Liquid PRF Injection for Under-Eye Treatment and Perioral Rhytids

Dark circles, under-eye hollows, and fine lines around the mouth (perioral rhytids or “smoker’s lines”) are some of the most challenging areas to treat in aesthetic medicine – but Platelet-Rich Fibrin (PRF) injections offer an exciting, natural solution. PRF is an advanced form of the better-known Platelet-Rich Plasma (PRP) therapy. By drawing a small amount of your blood and processing it in a very specific way (low-speed centrifugation without additives), we concentrate your platelets, fibrin, white blood cells, and stem cells into a golden serum. This “liquid gold” is then injected back into target areas to stimulate healing and regeneration.

Unlike PRP, which is typically injected or microneedled immediately and is in a fully liquid state, PRF has a fibrin matrix that forms a gel-like consistency once injected under the skin. Think of it as your own slow-release rejuvenating filler. It holds all those growth factors in place and releases them over time as the fibrin matrix gradually dissolves. This makes PRF particularly suited for delicate areas like the under-eyes, where skin is thin and traditional fillers can sometimes look lumpy or cause issues. PRF works to improve hollowness, texture, and color in the under-eye by boosting collagen and blood supply in that area. Similarly, around the mouth, PRF can help soften fine vertical lines by enhancing skin quality and plumping from within, all while being 100% your own natural tissue.

Treatment Process

The PRF treatment begins with a simple blood draw – usually two small tubes of blood from your arm, similar to standard blood tests. We then spin these tubes in a centrifuge at a low speed. This gentle spin separates the blood into layers without completely isolating just platelets like PRP does. Instead, we get a layer that’s plasma enriched with platelets and fibrin (and some white cells). This processing takes about 10 minutes.

Meanwhile, we apply numbing cream to the areas we’ll treat (under eyes, or upper lip area, etc.) to make the injections more comfortable. Once the PRF is ready, Dr. Tokman uses a fine needle or cannula to carefully inject the PRF into the target areas. For under-eyes, typically a cannula (a blunt tip instrument) is used to minimize any bruising and to place the PRF in the tear trough region safely. A few entry points are made with a needle, then the cannula slides in to distribute the PRF uniformly. You might feel a little pressure or a slight sting, but most patients find it very tolerable, especially with topical anesthetic applied.

For lines around the mouth, we may inject small aliquots of PRF directly under the wrinkles or use a cannula technique as well. The procedure for each area is quick – maybe 5-10 minutes of injection time per area. Because PRF is all natural and from your body, there’s no risk of allergic reaction. After injection, we might lightly massage the area to spread the PRF. You will have some swelling – particularly under the eyes, it’s common to look a bit puffy or even have a slight “tea bag” effect where the fluid sits, this can last 3-5 days. Plan for that mild swelling; it’s usually not dramatic, but you’ll notice it. Bruising is possible but with cannula it’s minimized. Many people have little to no bruising.

Pre- and Post-Care

Before Treatment: In the week before, hydrate well – being well-hydrated can make it easier to draw your blood and potentially yields more plasma volume. Avoid excessive alcohol the night before and of course, stay away from blood thinners and anti-inflammatories (aspirin, ibuprofen, etc.) if possible for a few days prior to reduce risk of bruising. Arrive without makeup on the areas to be treated. If you typically get cold sores and we are injecting around the mouth, let us know – we might start you on a preventive antiviral as any needle procedure around the lips can potentially trigger a cold sore in susceptible individuals.

Aftercare: One big plus of PRF is minimal downtime beyond some swelling/bruising. After treatment, we’ll have you avoid strenuous activity for the rest of the day and maybe the next day – physical strain can increase swelling. Don’t press or massage the treated areas for at least the rest of the day (we want the PRF to stay where we placed it). Avoid makeup until the next day to keep injection sites clean. Sleep with an extra pillow to keep your head elevated for the first night if under-eyes were done; this helps fluid settle. For under-eyes, using cool compresses (gently, not heavy ice packs) off-and-on in the first 24 hours can help minimize swelling. Do not put arnica or any creams near the eyes unless we advise – just keep it clean and dry. For around the mouth, similar care: ice packs (wrapped to avoid ice burn) can help with swelling or any lip injections if included. Expect that under-eye area to possibly look a bit “full” for a few days – this is normal and will resolve as the PRF releases its factors and the fibrin matrix is absorbed. We usually advise not to schedule any major social events for at least 3-4 days just in case you have bruises or puffiness, especially for first time patients as we see how you respond.

We often perform a series of PRF treatments: typically 2 sessions spaced 4-6 weeks apart for optimal results, particularly for under-eyes where improvement tends to be gradual. Some patients even do 3 sessions if tear troughs are very hollow or dark. Maintenance can be one session every 6-12 months. We will tailor the plan to the severity of the concern and your schedule.

Frequently Asked Questions

How soon will I see results under my eyes or around my mouth?
PRF is a gradual rejuvenation technique, not an instant filler. So patience is key. Under the eyes, some people notice improvement in crepiness or color within 2-3 weeks after the first session – you might see that the area looks a bit more rested as new collagen starts to form and blood flow improves. However, the major changes often become apparent after the second session and beyond. By about 6-8 weeks after your second treatment, you should see reduction in hollowness (the tear trough is less sunken), finer texture (fewer fine lines), and possibly lightening of dark circles due to improved volume and vascularity. Around the mouth, fine smoker’s lines begin to soften over a few weeks as well; deeper lines may need additional procedures (like resurfacing or a bit of filler) but PRF will improve the skin quality for sure. The results tend to build up – even a single session triggers weeks of ongoing regeneration. Many patients are delighted when they compare before/after photos a couple of months later. The look is very natural – you just appear more refreshed. If you’re expecting the immediate change that a filler would give, PRF might seem subtle at first, but its payoff is that it’s your own tissue doing the work, so it looks and feels completely natural.

How long do the effects last?
After a completed series (say 2-3 treatments), the improvements from PRF can last about 6-12 months. It varies from person to person. Because we’re boosting your own collagen and skin structure, some effect might even last longer (for example, collagen you built is yours to keep until aging or other factors break it down). Many patients will do a single maintenance PRF injection annually to keep the stimulation ongoing. Some combine this maintenance with other treatments – for instance, alternating PRF with a filler touch-up or with PRP facials. If you do nothing after a PRF series, your under-eye or lip area will eventually continue to age, but you might still be better off than if you had never done PRF, even a year or two later, because of the collagen and improvements made. However, for optimal long-term results, plan on at least yearly refreshers. The good news is, if you decide not to continue, there’s no abrupt loss or reversal – since PRF is not a foreign substance that disappears, you just gradually resume natural aging from the new baseline.

Is PRF better than filler for under-eyes?
They serve different purposes and often complement each other. HA fillers under the eyes can give an immediate correction of hollowing, but they carry risks like Tyndall effect (a bluish hue if placed too superficially) or puffiness if you happen to retain water, etc. Fillers also, if not done very carefully, can sometimes show or create a slight unevenness in that delicate area. PRF, on the other hand, is all natural and tends to improve the skin itself – it thickens the dermis, improves color and texture, and gives a mild volume increase by stimulating collagen (but not as much volumization as a filler would). If someone has very deep tear troughs, sometimes the best approach is a little bit of filler to rebuild the lost structure, combined with PRF to enhance the skin and address the dark circle pigmentation or fine lines. PRF alone will definitely help hollow eyes but likely will not plump them as dramatically as filler could in one session. However, PRF has virtually no risk of lumpiness or allergic issues, and no risk of vascular occlusion (which, though rare with filler, is a serious concern). For patients who are nervous about filler or have had a bad experience, PRF is a wonderful option to naturally rejuvenate that area albeit more gradually. Some younger patients who are just starting to see changes prefer PRF to delay the need for filler. In summary, neither is universally “better” – it depends on the individual’s needs and preferences. We can even do PRF first, then add a touch of filler later if needed, or vice versa.

What are the side effects or risks of PRF injections?
Since PRF comes from your own blood, it’s extremely safe in terms of biocompatibility. There’s no risk of allergic reaction. The main side effects are related to the injection process: swelling (particularly under-eye as noted), bruising (usually minimal with our technique, but it can happen), tenderness at the injection sites, and very rarely, a small lump or bump if the PRF clots in one spot. However, because PRF is soft and not a large volume, any small bump is usually just swelling or a little trapped fluid that will resolve. Infection is a remote risk with any injection – we use aseptic technique to avoid this and have never encountered infection from PRF injections. Some patients might experience a headache or a heavy feeling if we do a lot of under-eye work – this is temporary and more related to the mild trauma of multiple injections in that area. We advise taking it easy that day; even sleeping a bit extra can help your body recover quicker. If you have any condition that affects your blood (like a clotting disorder) or you’re on strong anticoagulants, PRF might not be feasible – we’ll cover that in your medical history. Overall, PRF side effects tend to be mild and self-limiting. You’re basically healing from tiny needle sticks and letting your body’s own goodness do the rest.

Can PRF be used in other areas or for other purposes?
Yes indeed. PRF is a versatile regenerative tool. Aside from under-eyes and lip lines, we can use it anywhere we’d use PRP and more. For instance, PRF is great for acne scars – injected into depressed scars or used topically with microneedling to improve them. It can be used in the scalp for hair restoration (some studies suggest PRF may be even better than PRP for hair because of the slower release of growth factors). It’s also used in dentistry and orthopedics for healing wounds and injuries. In the aesthetic realm, we can also inject PRF into the cheeks or other areas to improve skin quality or in combination with filler to enhance results. That said, we often reserve it for where it shines: under the eyes (since filler is tricky there) and fine lines (where filler is too heavy-handed but skin boosters help). We can discuss any concerns you have – for example, some patients do PRF in the nasolabial folds or marionette lines instead of filler when they want something natural, though results are subtler. The science of PRF is expanding, and we’re excited to offer it as part of our holistic approach – using your body’s own healing power to give you a youthful boost.