PRF Treatment Consent
Platelet Rich Fibrin, or also known as “PRF” ?is a treatment whereby a person’s own blood is used. A fraction of blood (10-20 mls) is drawn up from the individual patient into a syringe. This is a relatively small amount compared to blood donation which removes 500cc. The blood is spun down in a special centrifuge ?to separate its components. The platelet rich plasma is separated and activated to allow the release of growth factors from the platelets which in turn amplifies the healing process. PRP is then applied or injected into the area to be treated. Platelets are very small cells in your blood that are involved in the clotting process. When PRF is injected into the damaged area it causes a mild inflammation that triggers the healing cascade. As the platelets organize in the clot they release a number of enzymes to promote healing and tissue responses including attracting stem cells to repair the damaged area. As a result new collagen begins to develop. As the collagen matures it begins to shrink causing the tightening and strengthening of the damaged area. When treating injured or sun and time damaged tissue they can induce a remodeling of the tissue to a healthier and younger state.
The full procedure takes approximately 45 minutes – 1 hr. Generally 2-3 treatments are advised, however, more may be indicated for some individuals. Touch up treatment may be done once a year after the initial group of treatments to boost and maintain the results.
BENEFITS of PRF: Along with the benefit of using your own tissue therefore eliminating allergies there is the added intrigue of mobilizing your own stem cells for your benefit. PRF has been shown to have overall rejuvenating effects on the skin as in: improving skin texture, fine lines and wrinkles, increasing volume via the increased production of collagen and elastin, and by diminishing and improving the appearance of scars. Other benefits: minimal down time, safe with minimal risk, short recovery time, natural looking results, no general anesthesia is required.
CONTRAINDICATIONS: PRF used for aesthetic procedures is safe for most individuals between the ages of 25-80. There are very few contraindications, however, patients with the following conditions are not candidates:
- Acute and Chronic Infections
- Skin diseases (i.e. SLE, porphyria, allergies)
- Cancer 3) Chemotherapy
- Severe metabolic and systemic disorders
- Abnormal platelet function ?(blood disorders, i.e. Hemodynamic Instability, Hypofibrinogenemia, Critical Thrombocytopenia)
- Chronic Liver Pathology
- Anti-coagulation therapy
- Underlying Sepsis
- systemic use of corticosteroids within two weeks of the procedure
- pregnant or breastfeeding.
RISKS & COMPLICATIONS: I have been informed that some of the Side Effects of Platelet Rich Flasma include:
- Pain or itching at the injection site
- Bleeding, Bruising, Swelling and/or Infection
- Short lasting pinkness/redness (flushing) of the skin
- Allergic reaction to the solution
- Injury to a nerve and/or muscle
- Nausea/Vomiting
- Dizziness or fainting
- Temporary blood sugar increase
RESULTS: Results are generally visible at 3 weeks and continue to improve gradually over the next 3-6 months with improvement in texture and tone. Advanced wrinkling cannot be reversed and only a minimal improvement is predictable in persons with drug, alcohol, and tobacco usage. Severe scarring may not respond. Current data shows results may last 18-24 months. Of course all individuals are different so there will be variations from one person to the next.
Your consent and authorization for this elective procedure is strictly voluntary. By signing this informed consent form, you hereby grant authorization to our medical staff to perform and/or to administer any related treatment as may be deemed necessary or advisable in the diagnosis and treatment of your condition.
The nature and purpose of this elective procedure and the complications and side effects have been fully explained to me. Alternative treatments and their risks and benefits have been explained to me and I understand that I have a right to refuse treatment. I agree to adhere to all safety precautions and instructions after the treatment. I have been instructed in and understand post treatment instructions and have been offered a written copy of them. I understand that no refunds will be given for treatments received. No guarantee has been given by anyone as to the results that may be obtained by this treatment.
I have read this informed consent and certify that I understand its contents in full. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I have had enough time to consider the information given me and feel that I am sufficiently advised to consent to this procedure. I accept the risks and complications of the procedure. I certify if any changes occur in my medical history I will notify the office.
I hereby give my voluntary consent to this elective procedure and release the facility, medical staff, and specific technicians from liability associated with the procedure. I certify that I am a competent adult of at least 18 years of age and am not under the influence of alcohol or drugs. This consent form is freely and voluntarily executed and shall be binding upon my spouse, relatives, legal representatives, heirs, administrators, successors and assigns.
I agree, if I should have any questions or concerns regarding my treatment / results I will notify this office at immediately so that timely follow-up and intervention can be provided.