APPLICATION OF INJECTABLE AND SOLID PLATELET-RICH FIBRIN (IPRF AND SPRF) IN RHINOPLASTY WITHIN THE CONCEPT OF LOW SPEED, HORIZONTAL CENTRIFUGATION WITH LOW CENTRIFUGAL FORCE (LSHCC)

Background: Achieving stable graft integration and smooth nasal contour remains a major challenge in rhinoplasty, particularly in patients with thin nasal skin and in revision procedures. Platelet-rich fibrin (PRF), prepared according to the low-speed horizontal centrifugation concept (LSHCC), represents a fully autologous biomaterial that combines regenerative potential with mechanical support. This study evaluated the clinical effectiveness of injectable plateletrich fibrin (I-PRF) and solid platelet-rich fibrin (S-PRF) as adjuncts for diced cartilage grafting and soft-tissue camouflage in rhinoplasty. 

Methods: A prospective observational clinical study included 1,568 consecutive patients who underwent primary or revision rhinoplasty between September 2009 and November 2025. PRF was prepared using horizontal centrifugation at 1000 rpm for 8 minutes (approximately 200 × g). Injectable PRF was mixed with finely diced autologous cartilage, whereas solid PRF membranes were used for graft stabilization, dorsal and tip camouflage, and soft-tissue regeneration. Clinical outcomes included contour smoothness, graft stability, wound healing, complications, revision rate, and patient satisfaction during a 12-month follow-up. 

Results: Among the patients, 1,320 (84.2%) underwent primary and 248 (15.8%) revision rhinoplasty. Septal cartilage was used in 1,333 (85%) cases and costal cartilage in 235 (15%). Excellent or good aesthetic outcomes were achieved in 1,396 patients (89%). Stable graft positioning and smooth dorsal contour were maintained in 1,537 patients (98%), with no clinically significant graft resorption. S-PRF eliminated the need for fascia or perichondrial graft harvesting in 100% of cases. Septal mucosal defects in 110 patients were successfully repaired with PRF membranes without postoperative perforation. No infections, hematomas, skin necrosis, allergic reactions, foreignbody reactions, or graft extrusion occurred. Minor contour irregularities requiring correction developed in 31 patients (2%), while clinically significant graft displacement occurred in only 2 patients (0.15%). No revision surgery related to PRF-treated grafts was required. Mean patient satisfaction was 9.0 ± 0.62/10, with 98% of patients reporting satisfaction or high satisfaction. Conclusions: Injectable and solid PRF prepared according to the LSHCC protocol appear to be safe and effective biological adjuncts in rhinoplasty. PRF enhances graft stabilization, improves soft-tissue healing, eliminates the need for additional fascial grafts, and provides excellent aesthetic outcomes with an exceptionally low complication rate. Further controlled comparative studies with longer follow-up are warranted.