Dr. Shervin Naderi demonstrates PRF injection technique on a patient, showing how to treat tear troughs, mid-face, and smile lines. PRF stimulates collagen while providing immediate filler-like support, unlike traditional PRP. The procedure causes swelling that resolves, with maintenance treatments planned.
Questions this video answers
Second treatment (maintenance) in six to eight weeks, then once a year.
27 gauge.
Chapters
I just closed my eyes. Okay. This is Tiffany. She's my beautiful esthetician. She's interested in doing some prf. PRF stands for platelet rich fibrin. And I like to equate it to like your body's natural filler, unlike prp, is a thick gel, so it's viscous. And we just made this out in the nursing station and PRF is like almost largely not replaced, but I'm 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 ever. It just stimulates collagen. But because it's gelatinous, it has a filler like effect. This is a two step procedure. We do the first treatment, your initial treatment kind of lays the foundation. And then second treatment, maintenance treatment, six to eight weeks later and then once a year. So Tiffany's areas of concern are the under eyes, which 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 gonna get started. Tiffany, you can just relax, close your eyes if you want. All right, this one is look full. Save that for the smile lines. They swing. Okay. One, two, three. Big, big pinch. 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. Pinch right here. Perfect. You're doing great. How are you feeling? Okay, not so much. So 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 like it's starting to kind of 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. So it's looking beautiful on her. Now a little bit lower. Let's, we want that mid face support. And here I'm injecting in the dermis. Nothing to stimulate at the level of bone here, but when the tear trough area with the skin being so superficial or the layers being so superficial and the skin being so thin, you can get everything being right at the layer bone. You can open your eyes so you see a little bit more fullness. But again, we want puffy through here at first. So patients will kind of be able to see their lower eyelid, which is fine. How are you feeling? I don't feel much. Good. Our nummy medicine is amazing. So I want a little bit more volume here so when that fullness kind of settles, it'll be right where we want it to be from a volume perspective. And then anyone who injects PRF knows that the needle will clog on you occasionally. 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 albumen of the blood makes it thick, and then the PRF is the collagen stimulating component. Colleen, can you grab me some extra needles?
Thank you.
That one needs to be replaced. This one's looking good. Just want one more drop right here. Big, big pinch. You're doing amazing. Still feeling okay?
You could totally see the difference between the two sides. The left side is so much hollower compared to.
Started on her worst side.
Yeah.
Kind of demonstrate that too. I sleep on that side.
Not related. Thank you, mom and dad.
Can you grab this little one for me?
This little bleeder calling the last straw is always the one that bleeds.
Always, always, always the very last drop.
Murphy's luck.
On the other side. So that went perfectly here. Off has a way of just kind of blending beautifully like your favorite thin filler. Big pinch, but you get the collagen stimulating aspect as well. Again, I want that swell. I'm not sculpting. PRF is. 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.
Colleen, put that ice in that little bleeder right there. The one you're holding pressure on. Go liver or needle. That way she won't bruise.
Perfect.
Looking good.
Excited. This is one of those procedures. Every time I inject it. I get jealous of my patients because I'm also a great PRF candidate. But maybe you don't have to zoom in on my eyes. But we'll do it.
Don't you worry.
We need having a little downtime, which often does not occur around the holidays. This one's a little bit clogged. I'm going to replace our needle. This is the time consuming part of prf, but it's well, well worth it. It's okay. Okay. You're doing amazing. Everything's going great. Big picture here. I just want to get a little bit more Fullness. There we go. Right in that medial canthus. That's an area when people smile candidly or really wide, you start to see skin thinning first. This is looking great. Lateral Tiffany is young and so this is mostly preventative. Open your eyes for me. Perfect. Again, you can see the swelling on the other side has already subsided a little bit because the liquid component does diffuse. Right here. Perfect. Now we're ready for smile lines. That's great. How are you feeling? When she opened her eyes, saw one more area I wanted to.
What size can a needle is that?
This is a 27. Has to be a little bit thicker so they can actually diffuse through tiny vein right here and avoid. Got it. Perfect. You okay?
Looks good.
All right, we have just enough to hit the smile lines. 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 at the piriform aperture 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 big amount there and come out. I love this injection. 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 appearance. So preventing it as well as treating it is great. But from a volume standpoint, the mouth cosmetic subunit and the cheek will have a difference. So we want them softened but not erased. When they're overfilled, they start to kind of give that snouty simian or ape like appearance, which is not cute, I think we can all agree. Looks amazing. Touch up the other side.
She's more of a right sided smurf. More of a right side.
How are you feeling? Good. Nothing? Keeping a good poker face for the camera.
No tears.
Again, we're 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 like Velour RHA2. 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 kind of a different injection technique, different mindset. Because this is a collagen stimulator. It's not a point and shoot volumizer. You're done, my love. Yay. So, again, you have to kind of tailor your expectations. We want to look. We just poked her face many times. She's going to have little pinpoint areas of swelling potential. She didn't bruise very bad, sadly, at all, if at all. And then we want to look a little swollen. Tiffany is young and her skin quality is excellent, so it's holding down that swelling a little nicely and evenly. But this is a perfect immediate PRF treatment result. I'm excited. Well, do you want to see? Yeah, definitely look. Wow. I know it's really swollen, but already looks so much better. I love this tail line so much. It always looks smooth after. Yeah. And then you get that skin effect as well to where there's less crepiness, less settling, less little indentations with. With all candid animations. But we're excited for results, and we'll be back in eight weeks for more.
