What Are PRF Injections Under the Eyes?

This is [our aesthetician]. She's interested in doing some PRF. PRF stands for platelet rich fibrin, and I like to equate it to your body's natural filler. Unlike PRP, it's a thick gel. So it's viscous, and we just made this out in the nursing station.

We're doing so much more PRF versus tear trough filler, because this is not going to get lumpy and bumpy. It is not going to be reflective on the surface. It's not going to look puffy. It just stimulates collagen, but because it's gelatinous, it has a filler-like effect.

This is a two-step procedure. Your initial treatment kind of lays the foundation, and then the second treatment, the maintenance treatment, is six to eight weeks later, and then once a year. So her areas of concern are the under eyes. She looks great, but she wants to make this look a little bit more full, the skin a little bit thicker. Then if we have some extra, we'll go through the smile lines. So we're going to get started.

So similar to filler, we're going to go down to bone, and then you want to fill 50% past your aesthetic endpoint. So I want this to look a little puffy today. I'm tracing right along the anatomical tear trough, and I'm pulling out just a little bit right above bone so I can get that skin effect for the collagen stimulation. And you can see it's starting to look perfect, and then we're going to go through again with another layer to make it look a little bit past perfect, so that we get the lasting results of volume.

Now a little bit lower, as we want that mid-face support, and here I'm injecting in the dermis. In the tear trough area, with the layers being so superficial and the skin being so thin, you can get everything right at the layer of bone. You can open your eyes. You see a little bit more fullness, but again, we want puffy through here at first. So when all this settles, we'll be right where we want it to be from a volume perspective.

Anyone who injects PRF knows that the needle will clog on you occasionally. I'm just going to sort this little clog out, because it's thick like filler. This is made of two things from a blood content standpoint. The albumin of the blood makes it thick, and then the PRF is the collagen stimulating component.

You can totally see the difference between the two sides. PRF has a way of just blending beautifully, like your favorite thin filler. Again, I want that swell. I'm not sculpting PRF. It's a collagen stimulator. So the more areas that it can diffuse to, the better your outcome will be. It's a totally different injection technique as compared to filler.

This is one of those procedures where every time I inject it, I get jealous of my patients, because I'm also a great PRF candidate. This is the time consuming part of PRF, the needle clogging, but it's well worth it. I just want to get a little bit more fullness, right near the medial canthus. That's an area where, when people smile candidly, really wide, you start to see skin thinning first. She is young, and so this is mostly preventative. Open your eyes for me. Again, you can see the swelling on the other side has already subsided a little bit, because the liquid component does diffuse.

Now we're ready for smile lines. This is a 27 gauge needle. It has to be a little bit thicker so it can actually diffuse through. Now in this area again, you're injecting a little bit differently than with filler, and sometimes I'll even use a cannula here. But I do a big pinch right here, go down to bone, and then I draw it all the way up and I kind of pause right in the dermis, make sure I get a good amount there, and come out.

If you know me, you know I love this injection technique, because in women our bone actually resorbs here. So it's both a preventative and a treatment injection point, to help soften the smile lines and prevent them from deepening. I always tell my patients, my 20-month-old son has smile lines. They're okay to have, but when your makeup is settling there and you're starting to see them even at rest, that's when it starts contributing to an aged appearance. Preventing it as well as treating it is great. So you want them softened but not erased. When they're overfilled, they start to give that snouty, ape-like appearance, which is not cute.

Again, we're at mid to deep dermis, similar to where you would inject filler. Sometimes I like to pull up all the way to the top with filler, especially my softer ones, but here we're collagen stimulating. So you're aiming for where the collagen lives, not where you want to fill in hollowness. It's a different injection technique, a different mindset, because this is a collagen stimulator. It's not a point-and-shoot volumizer.

You're done. So again, you have to tailor your expectations. We've just poked her face many times. She's going to have little pinpoint areas of swelling, potentially a little bruising, and we want it to look a little swollen. She is young and her skin quality is excellent, so it's holding that swelling nicely and evenly, but this is a perfect immediate PRF treatment result.

Patient: I know it's really swollen, but it already looks so much better.

Yeah, and I love the way it always looks smooth after. And then you get that skin effect as well, where there's less crepiness, less settling, less little indentations with animation. We're excited for results, and we'll be back in eight weeks for more.