by Jake Wardwell, D.O.
As an Integrative Medicine doctor performing Regenerative Medicine procedures, my goal is to treat the underlying cause of conditions. I started out treating musculoskeletal conditions with prolotherapy because as an Osteopath, I could see that for many patients, the underlying cause of their musculoskeletal complaints was due to weakness of the tendons and ligaments that hold the joints in place. I could see the same patient weekly and they would continually have the same problem unless I addressed the root cause of loose ligaments and weak tendons.
As I started working with Platelet Rich Plasma (PRP), I realized that the same healing response that I was initiating in tendons, ligaments, and cartilage could be put to use in the aesthetic realm. Below I will describe how I use Platelet Rich Plasma and other Regenerative Medicine procedures for facial rejuvenation, hair regrowth, healing of scars, stretch marks, and wounds, and sexual performance enhancement.
I started working with some Dermatologists who coined the term “Vampire Facelift” when referring to injections of Platelet Rich Plasma into the collagen layer just beneath the skin using an acupuncture-size needle. Platelet Rich Plasma contains growth factors that are able to stimulate the production of new skin, blood vessels and collagen.
After a “Vampire Facelift”, patients will notice a healthy glow to the skin in the first week, but the real effects take place over the course of the next six weeks as the stem cells are stimulated to form into new collagen, blood vessels, and skin cells. After the first treatment, patients will often notice a rosier glow to the skin, which is the result of better blood flow to the skin. Patients also notice a smoother appearance to the skin with decreased pore size from the new skin growth. The skin will appear firmer due to the increase in elasticity from the new collagen.
With subsequent treatments every 3-6 months, effects like lifting of fallen cheeks and filling of under eye troughs are noticed. One treatment is enough to notice a difference and give a healthy refreshed look, but it may be necessary to do three treatments in a year’s time to achieve some aesthetic goals. I will often intersperse treatments of Mesotherapy in between PRP treatments to help fertilize the soil in which the stem cells are growing. This helps us to target specific goals with specific nutrients.
The process of injecting substances in the upper layer of the dermis, where the collagen resides, is not a new one. The French have used a technique called Mesotherapy for the last 50 years. Mesotherapy involves the injection of rejuvenating nutrients just 2-4 millimeters under the skin. The idea is to bypass the layer of the skin called the stratum corneum, which is impenetrable to topical lotions.
The types of nutrients we inject depend on what we are trying to treat. For instance, if a patient says they are unhappy with sagging skin at the jawline, I would add some DMAE or Organic Silica to the standard Mesotherapy Facial rejuvenation cocktail of Hyaluronic Acid, Vitamin C, Procaine and B12. Unlike Juviderm or Botox, these nutrients do not work as a temporary filler or to paralyze a muscle. Rather, they provide the proper nutrition to rejuvenate the skin, increase the elasticity, and address the underlying cause of the problem.
Other areas of Aesthetic Medicine that are amenable to regenerative injections are hair regrowth, healing scars or stretch marks, and as an aid in sexual performance.
Hair Regrowth is best done as a part of a complete integrative medicine program, but I have seen great results from just doing Platelet Rich Plasma injections beneath the skin of the scalp in the area where hair is desired every three months. Other synergistic approaches would involve injecting Mesotherapy nutrients and medications like Biotin, Retin-A, and Minoxidil, all of which can play a part of enriching the soil of the scalp. At a deeper level, addressing hormonal imbalance, high cortisol levels due to digestive tract issues, or detoxification can be important in restoring the vitality and helping to support hair growth, which is a symbol of vitality.
Stretch Marks, Scars and Wound Healing
Stretch Marks and Scars respond remarkably to Platelet Rich Plasma, and occasionally I will have patients use a dermal roller with a topical compounded formula that helps to resurface that area and promote normal collagen formation rather than scar formation.
Platelet Rich Plasma was originally discovered by plastic purgeons who noticed that applying plasma topically to the incisions they made in the face helped the wounds heal without scars. This same principle can be applied to wounds that are not healing properly, or healing slowly.
Erectile dysfunction and female anorgasmia are other areas where the same underlying principles of increasing the vasculature and strengthening of muscles can address the underlying issues. It is well known that men can use Viagra or Cialis to help achieve an erection, but this works by temporarily increasing the blood flow to the area. With Platelet Rich Plasma, we are able to increase the number of blood vessels going to the area as well as increase the size of the muscle. I will often pair this with supplements that increase blood flow in the body, addressing low testosterone, and looking more deeply at the underlying causes of these issues, such as adrenal fatigue.
For women, injections into the area of greatest sensation, better known as the G spot, can increase the sensitivity of that area and allow women who previously could not achieve a vaginal orgasm to do so. Again, looking at the whole person is the most important aspect of any treatment regimen and often I will prescribe bio-identical hormones, including oxytocin, the “love hormone”, and address underlying issues that may be contributing to an unsatisfying sex life.
How PRP works
Platelet Rich Plasma is derived by drawing the patient’s blood, injecting it into a sterile container, and spinning it down in a centrifuge, which isolates the platelets and stem cells from the red blood cells.
There are a number of different growth factors that are concentrated in the platelets, including:
Epidermal Growth Factor: stimulates new skin cell growth
Platelet Derived Growth Factor: stimulates the multiplication of stem cells to promote the creation of collagen, bone and skin.
Vascular Endothelial Growth Factor: stimulates new blood vessel formation
Fibroblast Growth Factor: stimulates new Collagen formation
Human Growth Hormone: stimulates muscle formation and more.
The doctors working in the Musculoskeletal realm of regenerative medicine have traditionally been more scientific about their use of Platelet Rich Plasma. The research shows that having a platelet concentration of over 900,000 platelets/microliter increases stem cell stimulation by 400%, and having concentrations at less than 600,000 platelets/cubic microliter is no more effective than whole blood. Many systems on the market used by doctors doing the “Vampire Facelift” do not achieve platelet concentrations greater than 600,000/microliter. This is important because the more platelets there are, the more growth factors. Growth factors are what make the Platelet Rich Plasma (PRP) work.
Other factors that can contribute to the overall effect include the concentration of red blood cells and inflammatory white blood cells, both of which inhibit stem cell growth. Many systems that produce high platelet concentrations also concentrate red blood cells (causing the Platelet Rich Plasma to look red) and inflammatory white blood cells.
After performing head-to-head comparisons between multiple systems on the market, I have chosen one that I know produces the optimal cell profile. I have refined my technique of preparation to maximize the amount of platelets and stem cells that are found in the PRP and minimize the amount of red blood cells and inflammatory white blood cells.
Topical Growth Factors
As a means of continuing the stimulation of stem cells, I will often prescribe a topical growth factor serum to be applied daily. There are specific serums that are designed for facial rejuvenation, hair regrowth, scar prevention, wound healing and vaginal dryness.
Integrative and Regenerative Medicine
The path to wholeness involves being satisfied with who we are and flourishing as human beings. When looking at aesthetics through the perspective of Chinese medicine, it is apparent how much the outside can tell us about the inside. In this perspective, as in Osteopathy, there is an important relationship between form and function, beauty and health. Perhaps the ultimate beauty is what shines through us when we are in love or embodying compassion.
A truly integrative approach to health and wellness involves treating the whole person. Pairing Integrative Medicine with Regenerative Medicine to work both systemically and locally provides a more powerful approach for achieving the results that patients want.
Inner Beauty Meditation (Maitreya Meditation)
Starting with yourself and then to someone that you love, moving to progressively larger circles of friends and family, then to people you have grudges against or problems with, finally to the world, and universe.
Sit with your eyes closed hands resting in your lap to make a bowl between your two hands.
I wish Myself Peace, Love, Happiness and Joy.
I wish my dog Peace, Love, Happiness and Joy.
I wish my mother Peace, Love, Happiness and Joy.
Until you get to
I wish person who you had a problem with in the past Peace, Love, Happiness and Joy.
I wish the Universe Peace, Love, Happiness and Joy.
This aspiration of Peace, Love, Happiness and Joy is about recognizing the universal desire for these sentiments by all humans.
Connecting at this basic level with other people helps to foster a sense of humanity and a connection to the larger source of our existence. This spiritual practice cultivates a compassionate spirit and touches a place that only one’s imagination can affect. The more real you experience each of these sentiments, the more powerful the exercise becomes. A sense of Peace like you know you are completely safe, the feeling of Love we may have known in the past or present, a sense of Happiness like you couldn’t ask for anything more, and a sense of Joy simply that you exist. When these sentiments shine through a human, the result is Inner Beauty. The regenerative potential to produce inner beauty is within each and every one of us, and this is the root from which external beauty emerges.