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Secrets of a Beverly Hills Cosmetic Surgeon

with Robert Kotler, MD, FACS

Dr. Kotler's blog has now been retired. We appreciate all the wisdom and support he has brought to the WebMD community throughout the years.

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Thursday, April 14, 2011

The Vampire Facelift — More Nonsense or Not?

vampire

Photo: iStockphoto

A new procedure, known as the “Vampire Facelift” is getting a lot of buzz.

First, you need to know that a Vampire Facelift is not a bona fide face lift because it is not a surgical procedure; it cannot sculpt the lower face, neck and jaw-line, as does the standard and venerable face and neck lift.

The catchy title is play on words. You need to mentally extrapolate from the famous Bela Lugosi –as- Dracula horror movies to a vision of extraction of blood from your body — not by a vampire, but by a surgeon or anesthesiologist, mind you.

The VF is getting a lot of media attention because of its name, not because of spectacular results. It did not originate in Transylvania; maybe not even Pennsylvania.  I’m not sure where it got started, but this is the essence of the process, as I understand it: using the patient’s own blood, a mixture is prepared that is injected under the skin, which ostensibly will do some plumping and filling of the tissue under the skin.  Should the plumping be successful, then presumably, some of the signs of aging would be diminished. The proponents are hoping that such “self-filling” will be more permanent than the current crop of fillers.

I’m familiar with the basic science and technology of this variety of natural filler. The Vampire Facelift uses “platelet-rich plasma” as the filler. Platelets, very small fragments and a normal component of blood, are very valuable in healing. Their main function is to promote blood clotting when clotting is necessary, such as after an injury or surgery. They literally plug the holes in blood injured and leaking blood vessels.  Platelets are also rich in growth factor, and other chemicals and hormones that stimulate the body to generate healing tissue.

We use platelet-rich plasma in our face and neck lifting, neck sculpting, and extended neck lifting. We have also used it in rhinoplasty, septoplasty and turbinate resection to improve the nasal airway.  Everyone is in favor of less bruising, less swelling, and faster healing.  That is the reason why we employ platelet-rich plasma.

All surgeons are familiar with the non-cosmetic uses of platelet-rich plasma. In the universe of all surgical specialties, platelet-rich plasma has had a long and successful run. Reconstructive plastic surgeons and cosmetic surgeons adopted it from those worlds of other surgical specialties including chest surgery where the plasma is sprayed over the stitch lines to promote rapid healing and reduce leakage from reunited blood vessels

For our facial cosmetic surgery procedures, as I’m sure it is in the Vampire Facelift, and any other surgery, several ounces of blood are extracted from an available patient vein after the patient is under anesthesia. The blood is spun down, in a centrifuge, to concentrate the platelets. Then, with addition of other chemicals and substances, that platelet-rich fraction is extracted. Then, a “spray” is fashioned, so that this platelet-rich liquid can be spread onto the under surface of the skin and atop the deep tissues. The PRP (platelet-rich plasma) promote faster welding of the tissues. It has been very successful. We are very happy to have it in our hands.

Apparently, the same type of mixture is used by those performing the vampire lift. It is merely injected under the skin.  The body takes it from there. Presumably new fibrous tissue is generated, the tissues fill out and such plumping mimics the role of the traditional fillers.

I haven’t seen any good photographs or scientifically valid studies to support the advantage of this technique and product over the existing and ultra-successful fillers such as Restylane, Juvederm, Radiesse, Sculptra, and Artefill.

Is it safe? David Bank, MD, president of the New York State Society for Dermatology and Dermatologic Surgery, has stated, “We certainly looked into it, but I think there is probably isn’t much of a problem when it comes to safety”.

I would agree that, with respect to safety and the possibility of untoward reactions and complications, this is a low-risk undertaking for patients, because the product has been used for so long in other spheres.

Results? That’s another story. But it’s a big story because cosmetic surgeries and procedures are all about results. I cannot tell you whether this is worth your while. For me, the jury is still out. Cosmetic facial surgeons need to study the results and the longevity before we pronounce PRP a successful and mainstream treatment.  When I see some results — either good or bad — faithfully portrayed in technically consistent, medical journal-standard before and after photographs, I will update you.

~Robert Kotler, MD, FACS

Posted by: Robert Kotler, MD, FACS at 8:04 am

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