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Facial Plast Surg 2024; 40(01): 112-119
DOI: 10.1055/a-1987-3459
Original Research

Novel Applications of Concentrated Growth Factors in Facial Rejuvenation and Plastic Surgery

Guo Li 
1   Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, Sichuan University West China Hospital of Stomatology, Chengdu, People's Republic of China
,
Hang Wang
1   Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases, Sichuan University West China Hospital of Stomatology, Chengdu, People's Republic of China
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Abstract

Concentrated growth factor (CGF), which is a third-generation platelet concentrate product, exhibits good potential for repair and regeneration of soft and hard tissues, and has gradually attracted attention in the field of cosmetic plastic surgery. The purpose of this review is to summarize the application and research of CGF in the field of facial rejuvenation and plastic surgery. A comprehensive review of the literature about the applications of CGF in facial rejuvenation and plastic surgery was conducted in PubMed, Ovid MEDLINE, and Web of Science. According to the inclusion and exclusion criteria, a total of 22 articles were included in this review. In recent years, CGF has been applied in many aspects in the field of facial rejuvenation and plastic surgery, including skin photoaging, repairment of soft-tissue defects, rhinoplasty, hair loss, autologous fat transplantation, and scars. In addition, no significant adverse reactions have been reported so far. CGF is rich in high-concentration growth factors, which has great potential and application prospects in facial rejuvenation and plastic surgery. However, the applications of CGF still have some problems, such as the mechanism, time of decomposition, and long-term efficacy and safety, which are needed to be resolved in future.

Keywords

platelet concentrate products - concentrated growth factors - growth factors - facial rejuvenation - facial plastic surgery


Publication History

Accepted Manuscript online:
24 November 2022

Article published online:
10 January 2023

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  • References

  • 1 Mirković S, Djurdjević-Mirković T, Pugkar T. Application of concentrated growth factors in reconstruction of bone defects after removal of large jaw cysts–the two cases report. Vojnosanit Pregl 2015; 72 (04) 368-371
    CrossrefPubMedGoogle Scholar
  • 2 Chen X, Wang J, Yu L, Zhou J, Zheng D, Zhang B. Effect of concentrated growth factor (CGF) on the promotion of osteogenesis in bone marrow stromal cells (BMSC) in vivo. Sci Rep 2018; 8 (01) 5876
    CrossrefPubMedGoogle Scholar
  • 3 Park HC, Kim SG, Oh JS. et al. Early bone formation at a femur defect using CGF and PRF grafts in adult dogs: a comparative study. Implant Dent 2016; 25 (03) 387-393
    CrossrefPubMedGoogle Scholar
  • 4 Choukroun J, Ghanaati S. Reduction of relative centrifugation force within injectable platelet-rich-fibrin (PRF) concentrates advances patients' own inflammatory cells, platelets and growth factors: the first introduction to the low speed centrifugation concept. Eur J Trauma Emerg Surg 2018; 44 (01) 87-95
    CrossrefPubMedGoogle Scholar
  • 5 Yu M, Wang X, Liu Y, Qiao J. Cytokine release kinetics of concentrated growth factors in different scaffolds. Clin Oral Investig 2019; 23 (04) 1663-1671
    CrossrefPubMedGoogle Scholar
  • 6 Bonazza V, Hajistilly C, Patel D. et al. Growth factors release from concentrated growth factors: effect of β-tricalcium phosphate addition. J Craniofac Surg 2018; 29 (08) 2291-2295
    CrossrefPubMedGoogle Scholar
  • 7 Talaat WM, Ghoneim MM, Salah O, Adly OA. Autologous bone marrow concentrates and concentrated growth factors accelerate bone regeneration after enucleation of mandibular pathologic lesions. J Craniofac Surg 2018; 29 (04) 992-997
    CrossrefPubMedGoogle Scholar
  • 8 Wang F, Sun Y, He D, Wang L. Effect of concentrated growth factors on the repair of the goat temporomandibular joint. J Oral Maxillofac Surg 2017; 75 (03) 498-507
    CrossrefPubMedGoogle Scholar
  • 9 Wang F, Li Q, Wang Z. A comparative study of the effect of Bio-Oss® in combination with concentrated growth factors or bone marrow-derived mesenchymal stem cells in canine sinus grafting. J Oral Pathol Med 2017; 46 (07) 528-536
    CrossrefPubMedGoogle Scholar
  • 10 Saha PS, Doran M. Different in vitro activation methods for latent transforming growth factors (TGF)-β: considerable exogenous factors to promote higher mesenchymal-origin cell proliferation in a bioprocessing platform. Biomed Sci Eng 2014; 2 (01) 5-12
    PubMedGoogle Scholar
  • 11 Gianni-Barrera R, Trani M, Fontanellaz C. et al. VEGF over-expression in skeletal muscle induces angiogenesis by intussusception rather than sprouting. Angiogenesis 2013; 16 (01) 123-136
    CrossrefPubMedGoogle Scholar
  • 12 Dohan Ehrenfest DM, Doglioli P, de Peppo GM, Del Corso M, Charrier JB. Choukroun's platelet-rich fibrin (PRF) stimulates in vitro proliferation and differentiation of human oral bone mesenchymal stem cell in a dose-dependent way. Arch Oral Biol 2010; 55 (03) 185-194
    CrossrefPubMedGoogle Scholar
  • 13 Berendsen AD, Olsen BR. How vascular endothelial growth factor-A (VEGF) regulates differentiation of mesenchymal stem cells. J Histochem Cytochem 2014; 62 (02) 103-108
    CrossrefPubMedGoogle Scholar
  • 14 Fredriksson L, Li H, Eriksson U. The PDGF family: four gene products form five dimeric isoforms. Cytokine Growth Factor Rev 2004; 15 (04) 197-204
    CrossrefPubMedGoogle Scholar
  • 15 Heldin CH. Simultaneous induction of stimulatory and inhibitory signals by PDGF. FEBS Lett 1997; 410 (01) 17-21
    CrossrefPubMedGoogle Scholar
  • 16 Honda H, Tamai N, Naka N, Yoshikawa H, Myoui A. Bone tissue engineering with bone marrow-derived stromal cells integrated with concentrated growth factor in Rattus norvegicus calvaria defect model. J Artif Organs 2013; 16 (03) 305-315
    CrossrefPubMedGoogle Scholar
  • 17 Cabrera-Ramírez JO, Puebla-Mora AG, González-Ojeda A. et al. Platelet-rich plasma for the treatment of photodamage of the skin of the hands. Actas Dermosifiliogr 2017; 108 (08) 746-751
    PubMedGoogle Scholar
  • 18 Deng CL, Chang Y, Wan WD. et al. The effect of PRP promoting the expression of collagen and hyaluronic acid of light aging human skin fibroblasts in vitro. J Tissue Eng Reconstr Surg 2012; 8 (04) 201-203
    PubMedGoogle Scholar
  • 19 Wirohadidjojo YW, Budiyanto A, Soebono H. Platelet-rich fibrin lysate can ameliorate dysfunction of chronically UVA-irradiated human dermal fibroblasts. Yonsei Med J 2016; 57 (05) 1282-1285
    CrossrefPubMedGoogle Scholar
  • 20 Yue H, Zhou L, Zou R. et al. Promotion of skin fibroblasts collagen synthesis by polydioxanone mats combined with concentrated growth factor extracts. J Biomater Appl 2019; 34 (04) 487-497
    CrossrefPubMedGoogle Scholar
  • 21 Chen J, Jiao D, Zhang M. et al. Concentrated growth factors can inhibit photoaging damage induced by ultraviolet A (UVA) on the human dermal fibroblasts in vitro. Med Sci Monit 2019; 25: 3739-3749
    CrossrefPubMedGoogle Scholar
  • 22 Zhang M, Zhang T, Tang Y, Ren G, Zhang Y, Ren X. Concentrated growth factor inhibits UVA-induced photoaging in human dermal fibroblasts via the MAPK/AP-1 pathway. Biosci Rep 2020; 40 (07) BSR20193566
    CrossrefPubMedGoogle Scholar
  • 23 Boswell SG, Cole BJ, Sundman EA, Karas V, Fortier LA. Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy 2012; 28 (03) 429-439
    CrossrefPubMedGoogle Scholar
  • 24 Kalmykova NV, Skorobogataya EV, Berestovoy MA. et al. Comparative characteristics of platelet lysates from different donors. Bull Exp Biol Med 2011; 151 (04) 547-549
    CrossrefPubMedGoogle Scholar
  • 25 Mirochnik Y, Kwiatek A, Volpert OV. Thrombospondin and apoptosis: molecular mechanisms and use for design of complementation treatments. Curr Drug Targets 2008; 9 (10) 851-862
    CrossrefPubMedGoogle Scholar
  • 26 Bonazza V, Borsani E, Buffoli B. et al. In vitro treatment with concentrated growth factors (CGF) and sodium orthosilicate positively affects cell renewal in three different human cell lines. Cell Biol Int 2018; 42 (03) 353-364
    CrossrefPubMedGoogle Scholar
  • 27 Ohji M, SundarRaj N, Thoft RA. Transforming growth factor-beta stimulates collagen and fibronectin synthesis by human corneal stromal fibroblasts in vitro. Curr Eye Res 1993; 12 (08) 703-709
    CrossrefPubMedGoogle Scholar
  • 28 Zhou R, Wang M, Zhang X. et al. Therapeutic effect of concentrated growth factor preparation on skin photoaging in a mouse model. J Int Med Res 2020; 48 (10) 300060520962946
    CrossrefPubMedGoogle Scholar
  • 29 Sun W, Li T, Yao H, Kang L, Dong F. Effects of concentrated growth factor and nanofat on aging skin of nude mice induced by D-galactose. Physiol Res 2021; 70 (03) 425-435
    CrossrefPubMedGoogle Scholar
  • 30 Wang X, Chen XP, Zhao QM. et al. Clinical observation of concentrated growth factor (CGF) improving periorbital wrinkles. Chin J Aesth Plast Surg 2018; 29 (07) 402-405
    PubMedGoogle Scholar
  • 31 Li YJZ, Luo S, Xu KX, Hao LJ. Clinical observation of the injection of autologous concentrated growth factors (CGF) in the improvement of facial inflammaging. Zhongguo Mei Rong Zheng Xing Wai Ke Za Zhi 2019; 30 (04) 236-239
    PubMedGoogle Scholar
  • 32 Sohn DS, Heo JU, Kwak DH. et al. Bone regeneration in the maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone. Implant Dent 2011; 20 (05) 389-395
    CrossrefPubMedGoogle Scholar
  • 33 Xu Y, Qiu J, Sun Q. et al. One year results evaluating the effects of concentrated growth factors on the healing of intrabony defects treated with or without bone substitute in chronic periodontitis. Med Sci Monit 2019; 25: 4384-4389
    CrossrefPubMedGoogle Scholar
  • 34 Chen J, Jiang H. A comprehensive review of concentrated growth factors and their novel applications in facial reconstructive and regenerative medicine. Aesthetic Plast Surg 2020; 44 (03) 1047-1057
    CrossrefPubMedGoogle Scholar
  • 35 Wang C, Wang ZL. Biology and role of ADSCs induced by CGF in regenerative medicine of rat full-thickness skin wounds. J Oral Maxillofac Surg 2016; 26 (04) 238-243
    PubMedGoogle Scholar
  • 36 Kao CH. Use of concentrate growth factors gel or membrane in chronic wound healing: description of 18 cases. Int Wound J 2020; 17 (01) 158-166
    CrossrefPubMedGoogle Scholar
  • 37 Zhao QM, Gao J, Huang XX, Chen XP, Wang X. Concentrated growth factors extracted from blood plasma used to repair nasal septal mucosal defect after rhinoplasty. Aesthetic Plast Surg 2020; 44 (02) 511-516
    CrossrefPubMedGoogle Scholar
  • 38 Liu P, Liu Y, Ke CN, Li WS, Liu YM, Xu S. Therapeutic effect of autologous concentrated growth factor on lower-extremity chronic refractory wounds: a case report. World J Clin Cases 2021; 9 (18) 4797-4802
    CrossrefPubMedGoogle Scholar
  • 39 Amato B, Farina MA, Campisi S. et al. CGF treatment of leg ulcers: a randomized controlled trial. Open Med (Wars) 2019; 14: 959-967
    CrossrefPubMedGoogle Scholar
  • 40 Calabriso N, Stanca E, Rochira A. et al. Angiogenic properties of concentrated growth factors (CGFs): the role of soluble factors and cellular components. Pharmaceutics 2021; 13 (05) 635
    CrossrefPubMedGoogle Scholar
  • 41 Hahn O, Kieb M, Jonitz-Heincke A, Bader R, Peters K, Tischer T. Dose-dependent effects of platelet-rich plasma powder on chondrocytes in vitro. Am J Sports Med 2020; 48 (07) 1727-1734
    CrossrefPubMedGoogle Scholar
  • 42 Gode S, Ozturk A, Berber V, Kısmalı E. Effect of injectable platelet-rich fibrin on diced cartilage's viability in rhinoplasty. Facial Plast Surg 2019; 35 (04) 393-396
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Dong WF, Han R, Fan F. Diced cartilage techniques in rhinoplasty. Aesthetic Plast Surg 2022; 46 (03) 1369-1377
    CrossrefPubMedGoogle Scholar
  • 44 Topkara A, Özkan A, Özcan RH, Öksüz M, Akbulut M. Effect of concentrated growth factor on survival of diced cartilage graft. Aesthet Surg J 2016; 36 (10) 1176-1187
    CrossrefPubMedGoogle Scholar
  • 45 Gürsoy K, Teymur H, Göktaş Demircan FB, Tanas Işikçi Ö, Gümüş M, Koçer U. Effect of platelet-derived concentrated growth factor on single-layer, multi-layer, and crushed onlay cartilage grafts. Aesthet Surg J 2021; 41 (05) 537-547
    CrossrefPubMedGoogle Scholar
  • 46 Chen X, Zhang R, Zhang Q. et al. Microtia patients: auricular chondrocyte ECM is promoted by CGF through IGF-1 activation of the IGF-1R/PI3K/AKT pathway. J Cell Physiol 2019; 234 (12) 21817-21824
    CrossrefPubMedGoogle Scholar
  • 47 Li ZJ, Choi HI, Choi DK. et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg 2012; 38 (7 Pt 1): 1040-1046
    CrossrefPubMedGoogle Scholar
  • 48 Justicz N, Derakhshan A, Chen JX, Lee LN. Platelet-rich plasma for hair restoration. Facial Plast Surg Clin North Am 2020; 28 (02) 181-187
    CrossrefPubMedGoogle Scholar
  • 49 Trink A, Sorbellini E, Bezzola P. et al. A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol 2013; 169 (03) 690-694
    CrossrefPubMedGoogle Scholar
  • 50 Steward EN, Patel H, Pandya H. et al. Efficacy of platelet-rich plasma and concentrated growth factor in treating androgenetic alopecia - a retrospective study. Ann Maxillofac Surg 2020; 10 (02) 409-416
    CrossrefPubMedGoogle Scholar
  • 51 Tan PC, Zhang PQ, Xie Y. et al. Autologous concentrated growth factors combined with topical minoxidil for the treatment of male androgenetic alopecia: a randomized controlled clinical trial. Facial Plast Surg Aesthet Med 2021; 23 (04) 255-262
    CrossrefPubMedGoogle Scholar
  • 52 Fang H, Liu Q, Cheng T. et al. Innovative use of concentrated growth factors combined with corticosteroids to treat discoid lupus erythematosus alopecia: a case report. J Cosmet Dermatol 2021; 20 (08) 2538-2541
    CrossrefPubMedGoogle Scholar
  • 53 Pu LLQ. Fat grafting for facial rejuvenation: my preferred approach. Clin Plast Surg 2020; 47 (01) 19-29
    CrossrefPubMedGoogle Scholar
  • 54 Pu LLQ. Fat grafting for facial rejuvenation and contouring: a rationalized approach. Ann Plast Surg 2018; 81 (6S, Suppl 1): S102-S108
    CrossrefPubMedGoogle Scholar
  • 55 Hu Y, Jiang Y, Wang M, Tian W, Wang H. Concentrated growth factor enhanced fat graft survival: a comparative study. Dermatol Surg 2018; 44 (07) 976-984
    CrossrefPubMedGoogle Scholar
  • 56 Zhang T, Dai J, Xu Y, Yu L, Wang X. Liquid phase concentrated growth factor improves autologous fat graft survival in vivo in nude mice. Aesthetic Plast Surg 2021; 45 (05) 2417-2422
    CrossrefPubMedGoogle Scholar
  • 57 Sun JL, Wang JJ, Cui ZJ. et al. Clinical effects of concentrated growth factor combined with plasma albumin gel in treating facial depressed scar [in Chinese]. Zhonghua Shao Shang Za Zhi 2020; 36 (03) 210-218
    PubMedGoogle Scholar