A Systematic Review of Platelet-Rich Plasma Versus Platelet-Rich Fibrin for Periorbital Rejuvenation

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have become popular autologous options for facial rejuvenation due to their regenerative potential and favorable safety profiles. The periorbital region remains one of the most challenging treatment sites, as conventional approaches such as hyaluronic acid fillers carry a risk of complications and may not provide natural, sustained results.

This systematic review aims to compare injectable PRP and PRF in periorbital rejuvenation, with emphasis on treatment protocols, efficacy, adverse effects, and patient-reported outcomes.

A PRISMA-guided search was conducted using PubMed, Embase, and Wiley Library. Included studies were evaluated for differences in preparation, injection techniques, frequency of treatment, clinical outcomes, adverse events, and satisfaction.

A total of 14 studies met inclusion criteria. Across studies, PRF was associated with improvements in skin texture, wrinkles, and crepiness, while PRP showed stronger evidence for treating hyperpigmentation. Both modalities demonstrated favorable safety profiles and high patient satisfaction, with only mild, transient adverse effects reported. Longevity of results remains unclear: PRF improvements often diminished by 6 months, whereas PRP outcomes for pigmentation were sustained at similar intervals.

PRF shows promise in improving periorbital texture and fine lines, while PRP appears more effective for pigmentation, but current evidence does not support the superiority of one modality over the other. However, the long-term durability of PRF remains uncertain, with improvements often diminishing by 6 months. Larger randomized controlled trials with standardized, objective outcome measures are needed to clarify their long-term efficacy.