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Stem Cells & The Vampire Facelift

If you attend medical conferences, or read the trade journals, you’ve no doubt heard about stem cells and their incredible potential in the healthcare industry. These cells have the ability to repair or replace damaged cells, reduce inflammation, and possibly even have a role in disease prevention and cure.

Lately, these cells have been the target of much interest in the cosmetic field. Platelet-rich plasma (PRP) is the portion of the blood that remains after centrifugation has separated out the red cells. This fraction is unusually rich in growth factors and stem cells, that have the ability to repair damaged skin, and act as a long-lasting filler to volumize the face. The PRP is activated using calcium, and then is immediately injected into the donor’s face.

At Canyon Lake MedSpa, we have been using the patented “Vampire Facelift” technique (Regen Labs) in conjunction with standard HA or CHA fillers. We inject the filler using standard technique and then layer the PRP on top. Although still very new to this technique, we believe we are seeing the early effects including improved skin tone and color. Research has documented significant prolongation of filler effect, but we have not been doing this procedure long enough to attest to that yet.

Since we are only minimally manipulating the blood (centrifuging and decanting off the PRP) in a completely closed system, and re-injecting it into the same patient, there is virtually no risk.

In our next article we will discuss, in greater detail, tips on collecting and injecting PRP, how to educate patients and the outcome of our patients’ results.

There has been tremendous interest in the very-well marketed “Vampire Face Lift” and we have experienced an increase in our Med Spa new-patient visits as a result of this interest.

Reader Comments (44)

Interesting that you're performing this treatment. I'd like to know your reaction to Dr. Lights previous post about the lack of evidence for stem cells in cosmetic medicine here:

I'm also curious about this new push into stem cells. I personally feel that the jury's still out but I'd be interested in hearing from those who are performing treatments with stem cells. I would guess that they'll become common in the next few years as docs are looking for ways to offer more/different treatments.

07.9 | Unregistered CommenterCHIMD

Will be watching out for the next article.. PRP is the next generation approach for patients seeking a natural method to combat the aging process.

07.10 | Unregistered CommenterRocco N.

i'm curious to know.. do you use DVT prophylaxis with facelifts?

07.10 | Unregistered CommenterSamuel Lin

There is very little stem cell in the circulating blood, if you collect the PRP portion of the plasma, it is still platelet rich, not stem cell rich. Try to put that into a stem cell counting machine, you will have a very poor cell count.

A true stem cell treatment most conveniently comes from liposuction, after fat collection, then you isolate the stem cells from the fat cells by collangenase enzyme, washing and purification, then re-inject on the face similar to the PRP procedure. That is a real stem cell treatment.

07.10 | Unregistered CommenterNK

Dr. Denes, are you using a centrifuge?

07.10 | Unregistered CommenterKath MD

There is very little evidence to show that this "vampire facelift" technique works effectively long term. This is mostly marketing spin, IMO. Please report back when you have patients who are at least 6 months out who have documented improvements. Our own pilot study patients with PRP alone as a filler had little changes past 3 months, and as a result, we no longer offer the PRP filler technique.

07.10 | Unregistered CommenterTF

As one of the earl and now-longterm-users of PRP in aesthetics, I have to interject here that the term "vampire lift" is truly disconcerting and does in my opinion hurt the entire field of regenerative medicine with PRP in aesthetics.
Secondly, I think, that there is still a remarkable lack of serious scientific data to proof e.g. longterm efficacy in e.g. combining PRP/PRFM with HAs as mentioned by the author here.
Further, there is a remarkable difference in quality between different PRP preparations which should be studied carefully.
It should be the aim of all of us to advance the serious approach to scientifically understand the clinical utility and the clinical outcomes of PRP/PRFM treatments.

Very interesting discussion. I have to agree completely with Dr. Zenker that "Vampire", while certainly memorable, isn't exactly a term that instills confidence or credibility in the practitioner. If PRP therapies pan out, I'll certainly be looking for another name.

07.11 | Unregistered CommenterCHIMD

I'm curious about how/where the PHP wiht HAs got started. Is this a simple combination of treatments that some have started using on their own or is someone promoting/training HAs and PHP?

07.11 | Unregistered CommenterLrgo

I have been doing PRP for a couple of years now. It in no way gives a facelift and I agree that the term Vampire should not be used. What it does do is help soften very fine "crinkle" type wrinkles when injected and the results last about a year. When applied topically with a dermaroller complete resurfacing occurs including removal of sundamage, lines and discoloration. Acne scars also diminish greatly over a series of treatments. I get results far better than fraxel, thermage, and RF lasers. Results are comparable to CO2 resurfacing without the downtime. The skin is regenerated, baby smooth, wrinkles reduced by 50-70%, simply beautiful. I do a series of 3 for the average person, 5 or more if acne scars. Results after a series is completed last 1 year. The pt should do a touch up at 1 year of 1-2 tx. Results in a pt compliant with SPF use, nonsmoking, healthy eating, retinols, etc are 1 yr. Poor lifestyle choices degrade results faster.

I also use it for cellulite and am seeing results particularly for horizontal bands of cellulite, the dimples do respond but take a bit longer. The skin becomes thicker and smoother, rejuvenated. It's the best and hopefully permanent solution to cellulite I've ever seen as compared to velashape and the lasers. I am not far along enough in my cellulite treatment pts to report on longevity.

I use PRP injected into scar tissue including stretch marks that are white. I combine it with a wound care/ulcer product to help regrow tissue. It works wonderfully breaking up the scar tissue initially with dots new skin and over time and treatments more and more new skin dots overcrowd the scar tissue, eliminating it. I also use wound care products if the pt has acne scars in my topical applications to the face. This does increase cost.

The major downside is pain. Facial application with a dermaroller requires multiple nerve blocks to the face and BLT. For cellulite its injected like mesotherapy which seems to be painful regardless of how much BLT is used due to the hundreds of little injections.

I find zero customers asking for it, some grossed out by it, it has not caught on yet. People hate to have their blood drawn. The cost factor is also fairly high, most clinics charge $3500-$5000 for a series of 3 without wound care products added.

Agreed, it will be interesting to see how PRP develops. I have seen excellent results with prolotherapy, injecting it into joints.

I used to work with a Dr. who harvested actual stem cells from fat or bone. They are then given in an IV with a hydrating solution (can't remember what it was) and the theory is they travel to the area where needed. I remember we treated an altzhimers pt and an erectile dysfunction pt and at follow up 3 months later all had improvement.

PRP/stem cells are definitly developing but slowly in this economy.

07.11 | Unregistered CommenterNPChappell

do you see a different clinical outcome using different kits/spinning methods/activation etc???

I have only ever activated with CaCl and used the same centrifuge. I don't have enough pt demand to invest in multiple centrifuges/kits so unfortunately can't be much help to you. I wish I could say otherwise because IMO it's an effective treatment.

07.12 | Unregistered CommenterNPChappell

i perform face lift of mid face using stem cells and fat after amplification ( my personal technique ) since 2005 and the outcomes are long-lasting and very natural

I totally agree with TF. The theoretical general concepts of PRP and stem cell therapy have hardly anything in common with the vast majority of applications used in enthusiastically marketed "vampire lifts". Aside of truly childishly sensational term, there are so many important variables that without standardization there could be no reliability expected.
As Dr. Zenker pointed out, there are different kits, different spinning methods, different activation and activation timing, anticoagulants affecting pH, deactivation of growth factors by low pH and, possibly, by higher concentration of platelets... all these components may play an important role in the effect of this particular therapy.
But to standardize, one needs a solid scientific support that is simply not readily available.
The revolutionary concept of stem cell therapy became exploited within the aesthetic industry by marketing "trendy"
stem cell treatments.
Fahd Benslimine, MD wrote very interesting editorial on adipose derived stem cells in January issue of Prime magazine : It nicely summarizes the problem of current state of our knowledge and application of stem cell therapy.
There is no doubt that stem cell therapy brings and unprecedented level of therapeutic possibilities in medicine. Yet, is there enough solid data to honestly offer our patients a "stem cell" labeled aesthetic treatment?

I use a centrifuge for facial grafting only. In my observation, it lasts longer because we only use low volumes.

07.21 | Unregistered Commenterj. combs

Thank you all for the interesting and thought-provoking comments to my post above. "NK" is correct, PRP is NOT high in stem cells. That was an error in my post. It has been very effectively shown, however, that PRP does attract stem cells to the site of injection, and thus repair/regenerate function. Interesting comments about the label "Vampire Facelift." It certainly is NOT a facelift, but the moniker Vampire is catchy and the remarkably high volume on their website attests to its effectiveness in attracting visitors. I am in complete agreement with my colleagues that a lot of research and observation still remains before we label this as "effective" but it our hands it does show promise. Response to "Kath ND," yes we centrifuge for a few minutes. To "Samual Lin," no I do not use DVT prophylaxis for facelifts (true rhytidectomies.) I usually finish within 3 hours, and since the patients are awake (I do them under local anesthesia) and encouraged to move their legs from time to time, I don't find the need for it. I DO however routinely use it (via lower extremity sequential compression device) for all of my abdominoplasties, as this procedure is clearly associated with a higher risk of DVT.

07.26 | Unregistered CommenterAlex Denes

Fat transfer is a very interesting topic. I too am using a centrifuge. But a lot of surgeons do not prefer this method. instead, they decant then aspirate, especially in large volume structural fat grafting.

Having used PRP for over 3 years, I echo Dr Zenker's sentiments and am also disappointed that some marketing person who thought themselves very bright coined and then started promoting the use of the term "vampire facelift" when referring to aesthetic applications of PRP. Presumably, this is because vampires have become recently fashionable but the general public isn't stupid and we should stop treating them this way. Unlike Dr Denes, I have not had a single positive comment by patients when I have asked them if they have heard of the "vampire facelift". This is all the more disadvantageous as PRP is a useful tool in aesthetic medicine. I agree more studies need to be done regarding its use in aesthetic medicine and certainly more standardisation is required due to the growing number of competing PRP systems.
I think it is perhaps a stretch to lump PRP and stem cell therapy together. Having attended the last Biobridge in Geneva a few years ago, it is apparent that the use of stem cells in clinical medicine is still in its infancy. PRP is the present and stem cells are the future (with the main exception being adipose derived stem cells). This is a field that is sure to grow in the years to come and there will be hiccups along the way.

Hi Dr. Denes and others

Your point is very correct. PRP itself has very little stem cells, but it will attract and wake up the local "sleeping" stem cells at the injection sites.

One can do a PRP collection at very cheap cost if you have a clean room and the proper centrifuge and BD tubes. Anti-coagulate most people use is sodium citrate, many people will use calcium chloride as activator, but I only use 2% lidocaine in the ratio of 1:10 as using ca chloride will start the cascade so quickly you have very little time after preparation and injection. Lidocaine in this instance acts as a activator as well as anti-bacterial property. It is still painful, even with 10% emla.

You can prepare a super PRP by centrifuge a second time and collect the last 1-2 cc of plasma, for specific site injection.

I am happy to discuss adipose derived stem cell procedure as a separate heading if anybody is interested.

08.13 | Unregistered CommenterNK

Hi Dr Denes and others.

Totally agree, PRP will attract and wake up the local resident "sleeping stem cell" at the injection sites. There will be a double effect from all the growth factors from the PRP as well as activation of local resident stem cells.

One can prepare a PRP by yourself if you have a clean room or a standard airflow cabinet. Centrifuge, sterile tubes. Most people will use sodium citrate as anti-coagulant. Many would use calcium chloride as an activator, but I only use 2% lidocaine in the ratio of 1:10, as an activator and it's antibacterial effect. One can get a "super PRP" if you do centrifuge more than one time.

As for adipose derived stem cell treatment is quite something different, and I would be happy to discuss as a different topic..

08.14 | Unregistered CommenterNK

Comment on NK notes dated 08.14.

In Europe only CE certified medical devices class IIa, which intended use is the preparation of PRP, can be used to prepare PRP. The use of sterile lab or IVD material is forbidden. Material for PRP isolation should be compliant with ISO 10993 norms (tested for biocompatibily, cytotoxicity, mutagenicity, dermal irritation, hemolysis...). Moreover the work under the laminar flow should respect GMP conditions.
Anyway with such lab technique the quality of the resulting PRP will depend on the dexterity of the operator and most MD don't have access to a lab with a laminar flow. It is therefore easier and safer to use adequate certified PRP devices that work in closed circuit.

Over concentrating the platelet to obtain a "super PRP" is not recommended. It is known from in vitro studies that excess of growth factor (or PRP) induces negative effect on cell culture. Same results are seen on patients, for example, Rappl LM et al. found that PRP with near physiological concentration (1 to 3 time blood platelet concentration) show better results for wound healing than too highly concentrated PRP. Read "Effect of platelet-rich plasma gel in a physiologically relevant platelet concentration on wounds in persons with spinal cord injury. Int Wound J 2011; 8:18.7–195" for more information.

08.16 | Unregistered CommenterS Vischer

Dear Vischer

With no disrespect, different countries have different laws. I have been using a kit from Israel for PRP which has CE certification for reinjection and 2 years ago also granted FDA approval for re-injection. I am mearly suggesting there can be a much cheaper alternative than using a kit from regene lab or other CE approved and FDA approved kid. When you have to buy a kid for US 120 dollars verses something which should cost less than 10 US dollars. Which is a total rip off.

When you are injecting your own plasma, where is the concern of biocompatibility, cytotoxicity and mutagenicity. Dermal irritation, may be.But PRP is autologous!

I am not suggesting the new comer of PRP should not be using a well approved kid, I am just suggesting there is an alternative, much cheaper in the long run if you happen to have a well equiped lab and GMP facilities.

Also, I am not suggesting the regular new comer should be doing the Super PRP regularly, that is a suggestion from Dr. Koturo Yoshimura, when you can prepare a better concentration of PRP for special situation, but he also recommend a dilution with normal saline after a collection of a super PRP for normal use.

08.17 | Unregistered CommenterNK

Dear NK,

PRP is autologous and of course totally biocompatible! However we are speaking of PRP devices. When you are using lab material to prepare it, can you guarantee to your patient that during the processing the PRP was never in contact with small particles or molecules such as phtalate, latex or any other irritant molecules? The high cost of certified kit is partially due to the high cost of theircomponents that have to be made with expensive biocompatible material.
And, with no disrespect, what is cost of half an hour work of a experimented technician in a GMP lab?

Concerning the method from Dr Yoshimura published in 2011, this a lab method to obtain the highest possible concentration of platelets. He is suggesting to use a final product that is not a PRP anymore as he is removing the plasma and remplacing it with saline, and use an anticoagulant known to hinder platelet functionality (EDTA). Who want to use unfunctional platelets in saline?

Platelets are not just growth factor containig vesicules. These tiny cell fragments are able to secrete factors in an highly orchestrated manner in response to their environment. In the wound healing cascade, the growth factors have sequential actions and their concentrations vary according to the different steps of wound resolution. Moreover the main growth factors found in PRP are well known, but what about the role of the other platelet secreted molecules (more than 300 described already)? And don't forget the role of the plasma itself as a source of many molecules essential for cell survival and growth.

PRP is not just a easy source of growth factors, it is a living product richer than that!

08.17 | Unregistered CommenterS Vischer

Dear Vischer

Thank you for all your comments. Obviously your are very learned and has vast experience in performing PRP treatments.

Because the original line started by Dr. Denes was on stem cells, my thought was already on stem cell isolation and therapy. And we probably should not be discussing PRP at all on this line. I am aware there is a well established line on PRP already at this forum.

Since my mind was on stem cell, especially on adipose derived stem cell application, I was automatically drawn to it, my fault,sorry, thinking in the line of stem cell isolation and naturally a well equiped GMP grade Lab. Never the less, I really want to speak out about the profit margin the big guys are making on their PRP kid. with no disrespect for intellectual property, you can get a PRP kid from Korea that can handle 30 cc of blood at one time at half the cost of any kid from Europe with CE certification. Korea has a KFDA approval standard which I think is not any lower than a CE standard.

Also, I have never use the "super PRP" myself so far, just a point for discussion.

Personally I don't use calcium choride as an activator because it started the cascade so rapidly that you really have very little time after preparation and injection.

I welcome any comment you will make and most happy to share any personal clinical experience regarding both PRP and stem cell treatments.

08.19 | Unregistered CommenterNK

we just started prp. i think it's great and extremely easy to do. we also incorporate a small % of lido in the prp to ease the pain.

Dear NK

Can you share your method of Fat grafting. Do you combine this with prp? I am not 100% sure that commercial kits have anything special or that they do improve results. PRP seems fascinating in theory but does it work in patients?

09.16 | Unregistered CommenterDr Sanjay

Dear Dr. Sanjay

I mainly do stem cell isolation from adipose tissue. This is mesenchymal stem cell. And only do autologous transfer.

Most of the time I first loosen the fat by Vaser system. Then aspirate the fat by 20 cc syringes. total of 50-60 cc of fat is enough for stem cell isolation for a full face treatment. You can aspirate your fat by just simple syringe aspiration if you don't have Vaser or other ultrasound system. You can also use the Bodyjet system (water jet). But you cannot use any laser lipo system cause this will destroy the living stem cells. Then you need to isolate the stem cells from the aspirated fat with GMP grade collagenase.

I have been doing PRP for 3-4 years average one treatment per day.

I started doing stem cell aesthetic treatment for 2 years, initially Not combining with PRP because I wanted to see the pure effect itself. I did observe positive result. Since this year I combine stem cell with PRP and I observe also positive results. Most people would combine PRP with stem cell because the PRP is acting as a nutritional support so the stem cell will survive much longer then stand alone treatment.

09.17 | Unregistered CommenterNK

Dear Dr Sanjay,

for PRP use and fat grafting you can refer to the work of Dr Cervelli and Gentille. They are using the Coleman technique to purify fat and then combine the fat with PRP for injection. They have shown that adding PRP increase fat graft survival

See the following links for access to two of their articles:

The standard mix is 20% PRP for 80% purified fat. You can increase or diminish the PRP volume depending on the final consistency desired.
One easy way to obtain an homogeneous preparation is to connect the syringe that contains the fat and PRP (for example 8 ml of fat and 2ml of PRP) to another empty syringe of the same volume using a connector (or a thee way valve) and to delicately transfer the mix gently back and forth for one syringe to the other until your mix is homogenous.

Gentile and Cervelli have used calcium for PRP activation. I don't think it is needed as natural activation will occur at the graft site. Moreover calcium is known to be irritant.

Concerning commercial kits, as I mentioned in former post there is first the regulatory and security issue as you need to use material that will guarantee the security of the patient. Close circuit systems allow the easy preparation of PRP at the bedside of the patient without the need of a GMP lab.

Second they are many devices to prepare PRP and the composition and quality of the resulting PRP vary enormously from one kit to another. Depending on the technology you will obtain PRP with:

- Platelet recovery from 40% (or even less) to 95%
- Platelet concentration from less than the one in blood to 10 times the blood platelet concentration.
For aesthetic use I would recommend to have a concentration factor between 1.5 and 2.5 time the blood platelet concentration. See my comment from 08.16 for reference about over concentrated PRP
- A very low number of white blood cells up to highly concentrated white blood cells.
PRP with concentrated white blood cells may induce high inflammatory reaction. Again for aesthetic use I would recommend a PRP with low or physiological concentration of white blood cells
- Variable contamination of red blood cells, that will slow down the regeneration process
- Variable quality of platelets. Platelets should be functional and maintain their integrity during PRP preparation

Some commercial kits are very low quality, not respecting local regulation. A good way to check the seriousness of the company selling the kits is to ask for the published results in the scientific literature done with their kits and the results of their PRP composition.

09.19 | Unregistered CommenterS Vischer

I have read that centrifuging the fat removes many of the stem and regenerative cells and may cause some trauma to the fat cells so I only decant the fat. I utilize the Tickle Lipo for fat cell harvesting because there is a higher survivability of the stem and regenerative cells.

10.29 | Unregistered CommenterRichard M.

Very interesting points. I am starting out with facial fat grafting in private practice. Previously I have used the centrifuge while training in London, but local colleagues seem to only decant. Also we were using it for reconstruction rather than for cosmetic applications. Any tips from my more experienced colleagues on getting best results and avoiding complications in the cosmetic/aesthetic facial fat grafting?

11.15 | Unregistered Commenteralva fanzo

Hi Alva
I have been doing fat grafting to the face for about 10 years with remarkable success (not because I'm so great at it, but because it's a great procedure!) And patients love it, because it is their own tissue. I was an outspoken skeptic about large volume fat transfers (breast, buttocks) until recently. I had a patient who kept having serious problems with breast implants, and I had to explant her several times. She begged me to try fat, and I did. With great success!! So I've changed my mind! The more I work with fat, the more I like it.

Regarding the face, here are a few things I've learned along the way:
1) I decant, rather than centrifuge. There have been papers indicating that centrifuging does not harm the fat cells, and I used to centrifuge regularly. But I found no benefit. As a matter of fact, uncentrifuged (decanted) fat just seemed richer and healthier to me (I know that's not very scientific!) and we've gotten great results. It also saves time by skipping a step.
2) When depositing fat, use small aliquots. This way, you can assure maximal survival of fat, and avoid lumpiness and fat necrosis.
3) Go as deep as you can with the reinjection. I try to layer on top of periosteum whenever I can (especially around the eyes and the infraorbital area.) The blood supply is much richer here, and I think enhances the chances of fat survival.
4) It is better to do several sessions than try to get everything accomplished in one sitting.
5) Don't freeze the fat for later use. I used to do this, but got poor results. Furthermore, you need a Tissue License (at least in California) to do this, and a constantly-recording freezer temperature device to assure that the freezer temperature did not change significantly "when you weren't looking!" and these are all expensive. And obviously you have to be extremely careful in labeling the specimens

Hope this helps Alva. I think you'll be very happy with the results of fat grafting.

11.15 | Unregistered CommenterAlex Denes

Thank you very much for your input Dr. Denes!

Does anyone use Platelet Rich Plasma? I use Platelet Rich Plasma instead and get better results. With PRP you benefit from the surplus of growth factors and also the physical properties of the thrombin as it tends to help separate the fat from excess fluid making decanting more effective. I begin with extracting the excess fluid from my fat sample and then add the PRP mixture. After the PRP is added, an additional 40% of fluid can usually be removed.

01.22 | Unregistered CommenterLilly Siv

Anyone familiar with tickle LIpo?

We use fat simply after decantation. Recently, we started using PRP to extract additional fluid. Sometimes we emulsify the fat a little by one or two passes from one syringe to the other. So far, no complaints.

02.6 | Unregistered CommenterKumar

Sometimes I use the centrifuge, I also decant.. I use PRP, after centrifugation o decantation. The procedure depends on the way of harvesting fat, the quantity and the elasticity of the skin.

03.3 | Unregistered Commenterbeaudin

The inventor of the Vampire Facelift was reluctant to be interviewed. They finally tracked him down. Here's what he had to say...

Are the results better and/or long acting? What are the advantages over typical dermal fillers?

04.1 | Unregistered CommenterSaylor

Hi, very interesting. I would like to know if PRP and stem cells injections works for laser burns in the face. I was burned by a pulsed dye laser 9 months ago and I have scars and collagen loss, I am very interested in regenerative medicine and what could be the best way to reverse this damage.

07.14 | Unregistered CommenterAPC

I use fat for reconstruction and cosmetic purposes. I use Platelet Rich Plasma after centrifugation o decantation.
The final result depends on the quantity, the way you harvest fat and the elasticity of the skin.

10.3 | Unregistered CommenterMaricon

I have been performing fat transfer for more than 15 years with excellent and long lasting results. For the face, I use a centrifuge with small cannulas to aspirate the fat and to re-inject again. For the buttocks, I use a manual centrifuge just to separate the fluids and re-inject in a multiplanar/tridimensional way with less than 20% of reabsorption. For the breast, just follow the Khouri technique, it is excellent. I do not believe the final result is related to the centrifuge but it is mainly proportional to the way you harvest the fat and how you are transferring it back to the body.

12.10 | Unregistered Commentergbetti

The VASER Lipo System is an excellent option for preparing fat for fat grafting procedures. The ultrasonic energy breaks apart the larger fat globules into smaller packets of 2 to 3 fat cells, which makes re-injection very fluid and helps the fat cells to revascularize upon reintroduction. Cytori Therapeutics recently conducted a multi-site study that confirmed the viability of VASER-treated fat at 85% and regenerative cells at 87%. The University of Pittsburgh Medical Center found the viability of VASER-treated fat to be over 80% six weeks post re-injection. Sound Surgical, who manufactures the VASER Lipo System, also offers a wide array of fat harvesting systems from small to large volume.

01.14 | Unregistered CommenterK.M.

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