PRP for Improved Sexual Function. International Society of Cosmetogynecology. Las Vegas 2018

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Cellular Medicine Association<–

Transcript

Dr. Marco Pelosi III: Our next speaker is probably best described as the Michael Jordan of platelet rich plasma, Dr. Charles Runels from Alabama, that pioneered the O-Shot® [Orgasm Shot®], the Vampire [Face]lift®, the P-Shot® [Priapus Shot®], and he’s taken all the abuse and he’s given the world some very, very useful procedures for everyone. He’s going to talk about the studies he did and the studies done in platelet rich plasma in regards to sexual function. Dr. Runels, it’s a pleasure to have you here.

Dr. Runels: Thank you for having me.

I’m going to go through a whirlwind look at research that’s been done where people have used PRP to help with sex. Much of the research has been done by the people in our group, and I’ve described many of them in this room who have done this research. It’s a for-profit organization, but we pay for research, we pay for education, we pay for marketing for our providers. Just to echo what you just heard, sex is much more than about just having fun. Rainer Maria Rilke said it’s just so correlated to the creative experience that it’s affecting how we do our work, how you do your presentation, and how – of course – relationships and families.

I want to echo that sentiment, and remind us that back in 1980, if you look in ‘Urology’ – this was ‘Urology’ 1980 – the most common cause for erectile dysfunction was thought to be 85% psychogenic. Here’s a quote from ‘Urology’ where urologists were encouraged to become counselors, because most of erectile dysfunction was thought to be psychogenic. Of course, I’m echoing the penis stuff because if you take a penis and shrink it and unzip it, that becomes a clitoris. I’m thinking most of the research will eventually apply to that. Certainly, our attitude is applying because we’re back in the … We’re not, I’m preaching to the choir, but many of our colleagues are back in the 1980’s and saying the main thing we have for sexuality for women is counseling.

My thinking that perhaps, as you guys do, some of the pathology that applies to the penis may apply to the clitoris, and maybe some of these women are suffering from actual genital histopathology, not just psychogenic problems. We have this one FDA approved drug now for female sexual dysfunction that’s a psych drug, flibanserin. It’s a useful drug, but obviously, we need much more and maybe we should think in terms of systems, like we do for the rest of the body.

Platelet Rich Plasma.

Obviously, this is not a new idea. This is from, this month, over 9,000 papers indexed in PubMed about platelet rich plasma. Our orthopedic colleagues, our dentist, our facial plastic surgeons have worked with this, and all we have to do is take their ideas and then hopefully people in this room will extend what I’m about to show you and just take those ideas and adapt them to the genital space. Here’s some of the growth factors we know about. There are many more. They have these effects. These are good things for the genitalia. Down-regulating autoimmune response, proliferation of fibroblasts, new angiogenesis, the adipocytes enlarge and multiply – think labia majora, collagen production, neurogenesis and maybe some glandular function.

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There’s never, in all those 9,000 papers, I still cannot find one serious side effect. No granulomas, no serious infection. PRP is what your body makes to heal when you do your surgeries and help prevent infection. Obviously, there are always certain things that can happen, bruising and such, but if you have a serious life-threatening complication from PRP, you will have the first recorded in all of that 9,000 plus papers. That’s a nice thing.

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We have commercially available methods for preparing it, within 5 or 10 minutes of the bedside, and the devices are FDA approved. So you guys don’t get confused, obviously the FDA does not approve your procedures. That’s a doctor business. They don’t approve blood that belongs to you, just like your spit and your saliva and your skin. They tried, at one time, to control eggs and the gynecologists said, “Hell no.” So they don’t control eggs and they don’t control blood, but you should use an FDA approved device if you do this [approved for preparation of PRP to go back into the body].

Autoimmune Disease

Here’s some of the ideas about down-regulating autoimmune response. We have split-scalp studies showing that PRP helps alopecia areata better than triamcinolone. More hair growth that comes in thicker. Here’s rat studies looking at rheumatoid arthritis. What do we have in the genital space? We have lichens sclerosus. We did some before and after pictures where you use stem cells mixed with PRP, and before and after pictures show improvement. Of course, that’s two variables because you have stem cells and you have the PRP.

We took the same idea and just used PRP. Andrew Goldstein worked with me on this, and we had two blinded dermatopathologists. The protocol was biopsy, PRP, wait six weeks later, another PRP injection, and then six weeks after that, another biopsy. Two blinded dermatopathologists out of George Washington University did not know the before or the after. We showed statistical improvement in both the histology and symptomatology. Here’s our histology. You can see obviously, that’s the same magnification and we’re showing decreased hyperkeratosis. That’s obviously healthier tissue. A layperson could tell that’s better. Of course if you look at the gross pictures, lady on the left as you guys know, she has pain wearing her blue jeans. The lady on the right is back to making love to her husband. They’ve invited me into their close Facebook groups and I saw a post a few months ago. Quote says, “I was sitting next to my husband, whom I love, last night. I was afraid to hold his hand because I was afraid he would become aroused and I’m bleeding and hurting today.” That’s what you guys are helping.

We published that in ‘Lower Genital Tract Disease’. We extended it because it worked. We published this past January in the journal of the American Academy of Dermatology. You have some science to go do this now.

One of our providers, Kathleen Posey, who’s a gynecologist out of New Orleans, took this idea and then she said, “Let’s do some dissection in the office”, and she presented this in Argentina, published it in the same journal ‘Lower Genital Tract Disease’. Here’s one of her patients, where you can introduce [inaudible 00:06:44]. It had been 12 years since she had had sexual intercourse, penis and vagina intercourse, with her loving husband … 12 years. She was being followed by a dermatologist on high dose clobetasol. Kathleen dissected it out in the office and then injected PRP … 8 weeks later, she’s having comfortable sex with her husband. She’s now 3 years out. She’s had to be treated with PRP, not repeat surgery … PRP now, 2 other times a year apart to maintain that result. She now has a series of 60 or so patients that she’s now going to publish with similar results, where she’s dissecting out – as you guys know how to do – treating the [inaudible 00:07:27], but then following that with PRP injections to help the healing and decease the autoimmune response.

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That same doctor, Casabona, repeated his study with lichen sclerosus in men [BXO], and showed with just PRP alone … This study of 45 men with repeat treatments … It is cumulative, 2 to 10 treatments, the same thing. All of them stopped their steroids. None of them started back. Only one went on to have circumcision.

Peyronie’s

Peyronie’s disease, another autoimmune disease … This came out this month out of Wake Forest, where they took men and they followed their results with Peyronie’s disease. Not only did their Peyronie’s improve statistically, but they also improved their erectile dysfunction by 5 on that scale of 5 to 25 that the urologists use. For some reason, thankfully, they threw in one woman just for good measure, and showed that it helped her incontinence. They just tucked that in as an aftermath.

Ronald Virag, as you guys know as the legendary vascular surgeon who was first to present the idea of intracavernosal injections for erectile dysfunction, out of Paris. His big thing now is PRP for Peyronie’s. He just published a study where he showed that this is comparing PRP with Xiapex, which is a $50,000 series of injections, FDA approved version of collagenase. He showed that PRP works better with few side effects. There’s a risk of about 1 in 30, that actually go from a bent pencil to a fractured pencil and a limp noodle. You don’t see that with PRP. You see the side effect is the erectile function improves. He showed the same thing, actually, in his studies that erectile dysfunction improves by an average of about 7 on that 5 to 25 point scale.

Wound Healing/Scar Resolution

Let’s think about the [inaudible 00:09:29] literature. Look at this, there’s so much of this out there. This is looking at post-operative adhesions, lots of studies looking at scarring with microneedling and PRP. This is a split-face study comparing PRP with microneedling verus PRP … Excuse me, microneedling with saline or Vitamin C serum and split-faced studies in PRP wins. Dr. Sclafani did some studies in the cosmetic space looking at increased collagen production and fibroblast activity, and never a neoplasia documented. People worry about that. This is not indiscriminate blindness blind growth. You don’t worry about carcinogenesis when you do surgery and it’s the same PRP that’s causing healing. There’s actually some helpful immune processes that go on, that you could argue actually might help prevent cancer. I’m not going to make that argument but it might need to be made one day.

If you look further, here’s a wound healing study looking at reepithelialized exposed bone and tendon of the foot and ankle. When I took that and applied, this is a hypertrophic scar that was a year old from cortisone, and then using PRP and Juvederm or HA filler, this is a few days later, a month later, and that’s a year later. Now, take that and think, “How could I use that in the genitourinary space?” Doing that anecdotally, we have many of the members of our group are seeing help with episiotomy scars or dyspareunia, pelvic foreplay instead of injecting that pelvic floor tenderness with triamcinolone. Physiatrist for the past ten years has been using PRP, your sports medicine doctors. Now, when you palpate it, consider injecting with PRP instead. Dyspareunia from mesh and that unknown dyspareunia, we’re seeing this is where we need you guys to help extend the research. The science is there that it should help and it seems to be helping. Not 100%, but about 80% in people with dyspareunia.

Mesh Pain

Here is a look at a gentleman who did … He took the mesh out and then he patched the hole with a gel form of PRP and showed benefit. We’re finding anecdotally – no one’s done this study yet, here’s another one for you to pick up … I’m giving you low hanging fruit. We’re seeing anecdotally that if you inject in the distribution of the pudendal nerve, which seems to be inflamed in some women with mesh pain, that their pain will frequently go from 9 out of 10 down to 1 or 2 out of 10, without even taking the mesh out. Just another place where we need some research done.

Interstitial Cystitis

Here, we have rat studies looking at inflammation. Let’s think about this one. Here’s a rat study where they modeled cystitis and we are seeing in chronic interstitial cystitis without even infiltrating the bladder, just infiltrating in the periurethral space, some of our women are getting better. I’ve had two separate urologists call me and say, “Charles, I can’t believe it. I was doing this and expecting not this to happen. I have these patients now who have had chronic interstitial cystitis pain for years, and it’s gone.” Not 1005 but finding out who’s going to respond and who’s not and why, there’s a lot of variables that need to be thought about that you guys will hopefully do the research.

Penis Growth

Here’s a study that came out in the ‘Journal of Sexual Medicine’, where a guy took … the [inaudible 00:12:51] men who have an erection of 3 inches or less and then he treated them with PRP, combined with a pump, and showed that if you repeated it every time you did it, it grew by about 7 millimeters. I’ve always thought if I could give you a guarantee half an inch to an inch with anything, I’d get my picture on a postage stamp. I don’t have that yet, but I can tell you that we’re seeing about 60% of the time we do this procedure, men will see some sort of growth.

If you look at the neovascular space, there was a study out of Southern California that was published in the ‘Journal of Sexual Medicine’ where they transferred adipocyte stem cells to the penis of diabetic rats. They showed new endothelial cell growth and increased nitric oxide activity in the dorsal nerve. Would that be helpful in the clitoris? Probably, but the interesting thing is the adipocyte-derived stem cells were attacked and they died. The postulate was the improvement was from the growth factors.

Penile Rehabilitation and Erectile Dysfunction

I have seen what [inaudible 00:13:52] have seen in that when you inject this in the penis, erectile function goes up on the average of about 5 to 7 per injection. Think about nerve repair. We have rat studies modeling prostrate surgery, showing that the nerves improved with PRP and so we have, again, another clear place where we need studies if you add this now to the usual protocol for rehabilitating the penis post-prostate surgery … would you see benefit? We have seen that in some of our patients who are a year or two out who failed the rehabilitation part of that. Would that help your patients who have, say, numbness and decreased function from riding their bikes too much, or trauma? I don’t know, but it’s worth thinking about and publishing research about.

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In thinking about where to put this, where we do our O-Shot, when we do PRP to the anterior vaginal wall, we’re putting it as distal from the bladder as possible. We found that it works better. We’re essentially making a liquid sling. Think infiltrating and getting ready to put in the mesh. That’s what we’re doing. Very simple, only we’re using a material that has never caused a granuloma ever. Doing that, frequently our patients will have their incontinence go away that day from the actual liquid and as it’s replaced with new tissue, it never recurs. Usually, you’ll have to repeat the procedure at a year or two out depending on the etiology. Sometimes it lasts longer.

The interesting idea is what might be happening with those [inaudible 00:15:21]. They become more active, and does that help with sexual function? The other place we put it is in the actual corpus cavernosum of the clitoris. We use [inaudible 00:15:29] ultrasound visualization and see it flow down into the body of the clitoris by the pubic ramus and the wave form goes to what you see in a flaccid penis to what you see in an erect penis.

Improved Orgasm & Libido in Women

That’s my time, almost done. Just 30 more seconds. Here’s a pilot study we did where we showed that in women with female sexual distress, that it dropped by an average of 10 and female sexual function went up by 5 when you do what I just showed you. Here’s a study that Dr. Neto, who may be here, published where he looked at incontinence and sexual function down in Brazil and showed that 94% of the people loved it. The question here is how would you combine it with your energy source? It works great in the face if you do laser and follow it with PRP … better results, faster healing. Is it going to … We need people to help us work out the algorithms. Not everybody has laxity, but when you have something, when do you use which treatment and when do you combine it with PRP? We need those answers, because I don’t have them yet. This is possible helps.

I am done. Thank you very much for having me. I put all these references at that website, if you want to go download them. Thank you. You guys have a wonderful conference.

Dr. Marco Pelosi III: Thank you Charles. Beautiful

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Who is Charles Runels?

The normal time for physicians to accept a new procedure is 20 years (10 to do the research and another 10 for physicians to routinely offer).

Case examples..
2. Antibiotics for Gastric Ulcers. Barry Marshall won a Nobel prize for the discovery. He gave up gaining acceptance in Australia, then came to the US and only after the popular press started talking about it did physicians start reading his research. He GAVE HIMSELF an ulcer by drinking the bacteria.
Ulcers were BIG business (they cut them out and made many $ with surgery and Tagamet®. People assumed the cause was already known and quit looking for another cause…so they were not interested in Dr. Marshall’s research.
Guess what? Now, midurethral slings are BIG business so “who needs another way?”
I don’t claim to be on the level of Drs Marshall and Forssmann but both of these 2 men inspired me. I actually pulled up Dr. Forssmann’s story on Wikipedia and read it for a few minutes to get psyched out before I injected my own penis with PRP (which I did twice before I injected any other person’s penis or clitoris/vagina).
Now, as you see the response of physicians to my procedures, you can see so many physicians who don’t see that they don’t know what they don’t know. It’s OK, it’s the natural course of things. Hopefully it won’t take the usual 20 years before we finish the needed research & women are routinely offered the option of an O-Shot® & men a Priapus Shot® procedure.
Charles Runels, MD

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Q & A. Leveraging National Press, Vampire Breast Lift®, O-Shot®, P-Shot

Vampire Breast Lift® procedure in the Sun
Vampire Breast Lift® procedure in Daily Mail (Bec Judd)

From an open-mike discussion sponsored by the Cellular Medicine Association (for our members only)

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Charles Runels: So thank you guys for coming. We have quite a few questions. Before we get started with the questions, I thought it might be helpful to talk about what I call flow marketing, or you can call it vampire marketing, if you want, but the idea is that instead of trying to spend a lot of money trying to be how big you can be, it’s to [00:00:30] use something that’s already big, and then tap into that, to bring attention to what you’re doing.

Flow or Vampire Marketing

For example, when something is hot, like when I came up with the Vampire Facelift name, all the vampire movies were popular at the time, and so it helped promote our name, it blasted off, and then by that same token, for example right now, it’s the Halloween season, [00:01:00] so you’ll start to see things like this. This came out today. October 4th in today’s New York Post, and every Halloween the news loves to talk about our procedures, but the vast majority of our people never take advantage of that. Consider another way to think about this is think about this would be like you are tapping into … It’s like putting your paddle, your windmill in [00:01:30] the wind, or putting your paddle wheel in a stream.

So whenever everyone’s, a lot of people are thinking about Halloween, that’s exactly why you’ll see the newspapers start talking about Halloween stuff, because they also know that that’s going to bring a lot of readers, which is going to make people click on their ads, which is why they stay in business and get to buy groceries, [00:02:00] by having a website. So you can do the same thing. Now, if you go onto our … Well, let me give you specifics of what I would do right now.

This is the time to take something like this, and I’m going to put this link into the chat box, and I would take this link and put it wherever you’re putting things, like you can put it in your … Okay. Wait a second. Let me paste it. [00:02:30] There it is. So wherever you can put that on a Facebook page, if you have it.

Here’s 2 Pages to Share if You do the Vampire Breast Lift…

1.

http://www.dailymail.co.uk/tvshowbiz/article-4962476/Bec-Judd-wants-vampire-breast-lift-fix-dark-nipples.html

2….

Forget vampire facials! Vampire BREAST LIFTS are the latest bloody beauty fad

You can go into an email that can be simply three lines. It could say, “Hey, check out this thing on the New York Post where they were talking about increasing or improving the appearance of the breast using the Vampire Breast Lift, similar to the Vampire Facial.” So what you’ll see is our procedures all promote each other.

So for example, on the Vampire [00:03:00] Facelift website, I have a link that goes to the O-Shot. On the O-Shot, there’s a link that goes to P-Shot and back to Facelift, so they’re all talking to each other. It’s very similar to, say if John Grisham has a book, the best way he sells all his books is to come out with another book and then on the back cover of every book, there’s a list of all the previous books, so if you happen to read one and you like it, you’re going to read the others. So that’s how this works.

I call it flow marketing or vampire marketing, where you don’t [00:03:30] use your energy. You tap your marketing into someone else’s energy. Now I put a whole video just about that. I want to show you. If you go to the Vampire Facelift page or the O-Shot page, and then you go to the marketing part. I’ll just go. Let me log on. I’m on the O-Shot webpage. Let me go to the marketing so you can see. Then I’ll come back and answer some of these questions.

[00:04:00] Of course, is just you want to take care of your people, which our people do. That’s why the people who go to the extent to learn new techniques spend the kind of money and time that you guys do to try to take better care of your patients. I’m preaching to the choir, but the thing that doctors do forget, and I have to remind myself sometimes, is that it is not your patient’s [00:04:30] responsibility to know what you’re able to do, so I’m going to say that again. It is not your patient’s responsibility to know what I’m able to do. So lots of us don’t really enjoy making videos, including myself. I do it, I don’t pay as much attention to it as I used to. I’ve become more deaf to the criticism that happens and always happens, but if you forget yourself, that’s being self-centered.

If you forget yourself and you think of only two [00:05:00] things, you think of the person who has pain that you know how to take care of, and you think of all the solutions you know, not just the thing you’re trying to sell that day, but all the solutions you know of to make that pain go away, now you forget yourself and you just become all about letting that person know what you have in the easiest, cheapest, best way because that means you have to spend less resources to get that message out, which means you can put out more messages, so this is not just marketing tricks. These are efficient, [00:05:30] ethical ways to help you heal more people who are suffering.

So that’s what we’re doing, and it’s not about making yourself look big. It’s into tapping something. So let me get to where you can see this. If you go into this marketing part right here, there’s a video that I’ve put up that you might want to see later. If you want to make a do list for this call, I would say one of the things would be go to this page, and go to [00:06:00] this one. Leveraging the national press to bring patients to your office. 41 minutes. Leveraging national press to bring patients to your office. You can also say that tapping your practice into this, so what would it cost you to put an ad in the New York Post? But there’s an ad in the New York Post. It’s an article, which is much better than an ad, but your patients maybe don’t see this page, and if they do, maybe they don’t know that you [00:06:30] know how to do that.

So I just gave you a simple way to take … I just put in the chat box. You can take that link that I just put in the box, and you could put that in a Facebook post, and when you do that, it looks like this. That’s how it shows up, and I’ll show you what that looks like so you could also just click this link, but you could also go to a page, so I’ll go to the Vampire Breast Lift page and let you see how this works in real time. So if I go to [00:07:00] our Vampire. We have a Vampire Breast Lift page. Where is it? Well, I don’t see it right now, so I’ll put it on the Vampire Facelift page. How about that?

So if I go to the Vampire Facelift® page and I just copy that link, so I’m just copying it out of the URL, and then I make a post, watch what the software does. So I just [00:07:30] posted the link, but then boom, it pops the picture, it finds the link and pops it in there, and now I can actually take this out and type something in. Do you see how you did that? You can do that very same thing with the link I just did, put that in your Facebook page, put it in your whatever, [00:08:00] and then yours, instead of saying up here, Just in Time for Halloween, you can say, “Offered in our office. Call us.” Tell people what to do. “Offered in our office. Would love to take care of you. Call us.” Something like that.

And then what they do is they say, “Oh, my doctor knows how to do this? That’s cool,” and then they call you. That’s called tapping the flow, and you’re constantly looking for what’s out there, not even what’s specific to the procedures you’re doing, but maybe they’re related, [00:08:30] so maybe Kim Kardashian or some movie star just did something that’s related to what you do, but not exactly, so then you could talk about that, and then say what you’re offering, so I call that tapping the flow, and along those same lines, I intend, because it’s Halloween time, to push and talk more about this month, I will be talking more about the Vampire Wing Lift because it’s time for something new.

We’ve all been following this, but many of us who do the O-Shot have been doing that [00:09:00] now for the past five years. I’ve been teaching it for the past four, and many of our providers have been doing that, so it’s time to start rolling that out and letting people know about it, so if you want to tap into that, if you go to our regular website. Let’s see. I’ll try to log in here. I’ll show you where you can see more about that because we will be talking about that this month.

[00:09:30] So we’re coming to questions. I just thought we’d start putting some marketing parts that are relevant and timely when we do these calls, and again, I always try to keep these less than an hour, hopefully shut them down in 45 minutes and they’ll be recorded and posted. So a lot of people were having trouble finding things. When you log in, this is our straight-up how to do the procedures page, but if you look to the side, what I’ve started doing is posting some of the blogs’ material over here, so here’s the [00:10:00] Vampire Wing Left [inaudible 00:10:02] labeled treatment-

Section 1 of 5 [00:00:00 – 00:10:04]

Section 2 of 5 [00:10:00 – 00:20:04](NOTE: speaker names may be different in each section)

Vampire Wing Lift®

Charles Runels: Vampire wing lift. Label treatments for orgasm, amnion, and then here’s some of the recent question and answer sessions. There’s last week’s sitting right there. So if you want to view that.

Really, really, useful, mostly about O-shot talk, where we interviewed Dr.Owings and Dr.Pose who had some very interesting things to say about the procedure.

Here’s about the amnion, which can be used for all these procedures. Talks [00:10:30] about it, you can order it there (that’s our special pricing) But here’s the Vampire wing life. I may not be able to do this, but I intend to make this (silence)

[00:10:41]

So [00:11:00] a video that shows you how.

The big thing I would say here, is that when you do this do not inject them separately. Mix the Juvederm in with the PRP, and it tells you how there. Mix it in with the PRP before you do this procedure so you get a nice emulsion and it’s not lumpy.

The other pearl I would say, is whatever [00:11:30] amounts of material you have put two thirds here and one third down here. So two thirds goes in the upper one half and one third of the material goes here. It looks odd and just looks unnatural if most of the material is down here. So that’s the way I distribute the material.

Okay. Vampire Wing lift, it’s a good time to talk about it. And this is the member side. If you want something to link to on the patient side and start putting something out there. Because whatever you put out there, [00:12:00] the first one to put out, search engines like it better. So if you just go to the patient side, and go to oshot.info and you want to tap into the Halloween thing. What you can do is you can make an email or a post and say, “Hey the New York Post is talking about the Vampire Breast-lift.” And you can see the actual article mentions the Vampire Facial, they goofed up and didn’t put our trademark there. So we’ll have to see if we can get them to correct that. But that’s okay they got our [00:12:30] name out.

But then in the same text you can say, “You might want to check out the Vampire Wing Lift.” And then if you go, same thing, now on the patient website for the o-shot. And right here I put a page, if you look in recent posts, I put a page over here, Vampire Wing-lift. So you can put a link to that page.

Now the thing about the wing-lift though, because it shows a picture of the labia, I would be careful [00:13:00] about posting this one to Facebook. It could be in a Twitter post, it could be in an email. But if you post this direct link to this page about the wing-lift … Well, it doesn’t’, it just has that video. So you could probably get away with it. If it had the picture then not so good.

If you play that video you’ll see why I have Rod Stewart in there. Wings are actually in one of his songs.

[00:13:30] And I’m going to go ahead and post this link, also. You can find it but I’ll go ahead and post that in the chat box too so you’ll have it.

Okay, I think that’s probably enough about marketing for now. Let me look at some of the questions.

Oh. I did want to bring up something that I think its huge, huge, huge, that a lot of people … I do it in my Hansel workshops but I’ve never had it on the [00:14:00] online workshops. I go through a little exercise here … I intent to post this to the memberships sights. And I recommend you guys watch this, and it will be in the marketing sections. 13 minutes about why you should offer money back on everything you do where you take cash. You will make more money, and you will have much happier patients, you’ll sleep better at night, life will be better for you in every way. People are afraid they’ll lose money by doing this. You will make much more money, and you will have much more patients [00:14:30] who are happy with you. And this tell you why and how to do that. And I will post this in the members section. So watch for it and I’ll send an email out when it’s done.

I call that marketing but you’ll actually wind up seeing more people for several different reasons. And you’ll see when you watch that video.

Ontraport

Okay, so I think that’s enough … Oh, one other quick thing about marketing, I promise this is the last one. I’m actually [00:15:00] in San Diego now, in a marketing class. Some of you guys who know me well know that I spend a lot of time and money trying to stay up to date so I’m sure I’m bringing you the best of the best. And I’m at a class in San Diego that’s put on my the Ontraport people. And some of you guys have signed up for Ontraport and maybe haven’t implemented. It’s huge, huge, huge what you can do with this. This is not just emails, and it’s not that complicated. But to implement please make use [00:15:30] of their help people. You just call the Naomi and know the guy the company, who started the company, and they take very special care of our people. If you call them after you sign up they’ll take care of you. Some of you have already signed up where I actually give you emails that were written in Ontraport, and there’s a reason I do that. Ontraport does things like postcards and a lot of other things that [00:16:00] A Weber and Constant Contact just can not do.

Even though I’ve use Ontraport for about seven years now, I haven’t really recommended it much until the past six months or so. Because I thought their tools were too technical and not user-friendly. But they’ve made them user-friendly. A good way to get started is just to go to oshot.info/tools and download this free book about how they think about emails. How they recommend it, [00:16:30] and then if you wind up getting Ontraport, I have a way of giving you 22 emails for free to send up. Go here, and sign up and read that thing, and implement it. It’s really easy. I’m going to put where that … I have that listed again in the chat box so that you can go get it.

Let’s see, hold on a second. It’s the same page where we sale other stuff, so some of you are already handing out books [00:17:00] and such. So that is oshot.info/tools. That’s where you get that free e-book.

I also still use Constant Contact, A Weber, Mail Champ, Ultra Cart, One Shopping Cart, Click Bang, so many different things. So when I tell you this is the best … Oh I’ve also used, Infusionsoft, and [00:17:30] I don’t know. I’m going to bore you if I tell you all of it. But too much money, and too much time. So when I tell you that this is the thing to do, I’m not guessing. I’ve spent money and a lot of time trying to figure it out. So oshot.info/tools.

And not everything that works for Mcdonalds or IBM works for a doctor’s office. So I’m telling you what works for a doctor’s office. And when I say that I mean ethical, educational, inspiring, helpful [00:18:00] ways that you can communicate with your patients and a side-effect is they know what you have to offer. And they’ll find you and not have to spend a lot of money doing that educational type marketing. So oshot.info/tools.

Okay. And when you get there, of course, there are other things that you can … Posters and such. But the main thing I’m telling you right now is go get this. And this is free by the way.

So I think it’s time to answer some questions now. And I’m glad we’ve got quite a few people on the call [00:18:30] so we can get some participation in getting these answered.

Priapus Shot®

So I am on the … We’ll start with the Priapus Shot, it’s kinda been ignored for a while. So let’s go into Priapus Shot and see, here’s one of the questions, see what it has, and hopefully you guys can help me answer.

And I’ll just unmute your mic. If you have a question [00:19:00] ask that too. I see Dr.Kelly has one, I’ll get to you in just a second Dr.Kelly. Let’s see, okay here we go.

Here’s the question, “Per your above education. I think the procedures work better if you activate the PRP with calcium chloride except with micro-needling where the tissue injury releases enough Thrombin to activate. Do you believe that PRP hair restoration should also activate [00:19:30] with calcium as well, prior to injecting?” Anybody doing hair that wants to comment on that? I’ll unmute your mic for you.

So, here’s what I think. I think with all the procedures you could make the case that they may work better if you activate it. My thinking though is that we’re seeing great results without activating, when it comes to hair. [00:20:00] My reasoning is, unlike say the O-

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Section 3 of 5 [00:20:00 – 00:30:04](NOTE: speaker names may be different in each section)

Charles Runels: My reasoning is, unlike, say, the [O shots 00:20:04], where you need the material to stay within a few millimeters of where it’s injected, because you want it close to the urethra, with the scalp, that’s sort of the exact opposite. You’d like it to spread diffusely, so you don’t have to do as many injection points. As a matter of fact, if you inject too much when you do the hair, you can cause it to hydrodissect down, and the eyes can be swollen shut the next morning. Of course, it goes away eventually, [00:20:30] and everybody’s happy, but I’d hear of that happening.

So, that’s my reasoning. I don’t think it’s needed. We have a lot of people doing amazing work, and lots of good, raving reviews, who do not use the calcium. So, I would stick to when you do the O shot, the P shot, and when you do loss of sensation of the nipple, all for the same reasons. You want it to stay where you put it, and it’s more therapeutic versus [00:21:00] cosmetic. Again, part of the danger of teaching, if you start to believe everything you say, so let’s do the research, and help me figure it out. Someone should do that study.

Okay, next question. Let’s see. I think that was all on the Vampire site that was not … That was on the P shot site. Okay, so here’s one, okay. Dr. Gaskill. Let’s look at this. Give [00:21:30] some guidance how to know where there are active hair follicles. Is it necessary to do the microneedling?

So, you don’t really know, but as a general guideline, you can see where the hair used to be, and if someone’s just bald as a cue ball, [00:22:00] I’m probably not going to do it. Usually there’s a receding hairline, and some thinning. What I usually do is just go ahead and treat everywhere there used to be hair. I don’t try to delineate exactly where the living versus all-the-way-gone hair follicles, where that borderline is. That’s the way I handle it.

It’s because I have seen some people where I just don’t think there was no way something was going to come back [00:22:30] there, and it did. Even some of our providers. Then, on the other hand, you have people where you just think it’s going to be the bomb, and nothing happens. I’ve seen a couple people lecture. One guy, out of NYU, he wrote a textbook on hair. Saw him lecture out at Denison, and he said after years of doing this, he still has no way of predicting. No blood tests, nothing. He just treats people, series of three, but after the second treatment, a month after treatment number two, if he sees no [00:23:00] results, he stops. But, he doesn’t really know until he tries.

Of course, it doesn’t mean because there is that unknown, you check thyroid, and you think about … I do. I think about IGF-1, and nutrition, and all that, but even with checking all that, you still can’t predict many of those who will fail.

Okay. Let’s see what other questions there are on the facelift website. [00:23:30] Anybody want to add to that? Let’s see. Here’s one. Where can I get more info on amnion and the hand lift? So, the amnion, to actually see where we have it, talk about it in particular, if you go to … Let’s see if I can show this for you. If you go on the [00:24:00] member site, and then you scroll up here to where the blogs are … Right there it says Hand Lift with Amnion. I think a lot of people just haven’t done a good job of showing people where that lives. So, if you want to know what’s recent, then look under Recent Posts.

You can also see who’s commented last. There’s [00:24:30] about how to do it, and I had some questions about Amnion, so I answered that there. There’s a little seven minute video. Then, you can purchase it there too. The prices there will be shocking compared to what you’re used to seeing from the number one providers. Wherever you’ve been buying it, we’re most likely getting it from whoever’s supplying that … from the person that’s supplying them. I think that answers that question.

[00:25:00] Let’s see what other question there was. This page. Oh, this is back on Priapus Shot. Going to shut that one down. There wasn’t no more questions. Then, on the facelift, I think there was one other question. [00:25:30] Recently purchased the pure spin system … There’s two more questions. One about cannulas, and one about PRP systems. Recently purchased a pure spin. Been training with Dr. Runels online. The direct injection of the PRP into the dermis is extremely painful. Mix with bicarb. It’s on back order. Okay.

[00:26:00] Yeah, isn’t it crazy that our laws … Every time I get one of these questions, it makes me sad that our laws are such that … Realize this is salt water, basically. Bicarb, calcium chloride. These are not narcotic, addictive things. These are not difficult to make in a sterile way. But, because of the rules with the compounding pharmacies, this makes salt water hard to find. It’s actually heartbreaking, to me. The place [00:26:30] that I go to that seems to be always, either they have it, or they can get it quickly, is … [inaudible 00:26:39] if you go back to our how to do it page, you go to the dashboard, and then you go … Scroll down to where I buy everything. Then, right here, it has all of it. It has my source, and it has [inaudible 00:26:57] phone number in there. So, that’s [00:27:00] where I would go.

After that, I really don’t have a good answer. Now, for the calcium chloride, you can also go to mrcrashcart.com, or whoever’s stocking your crash cart, and use those ampules, because that’s also 10% calcium chloride.

Let’s see. Think there was another question. Oh, it was about cannulas. Let’s see what the question was on cannulas. [00:27:30] I get that a lot. I can just start ranting about it, but I want to make sure that we answer this particular question. The general principle that applies to this, I think, and I see our expert injectors are divided about half and half, is that when you use a cannula, if you think about it, you have to make a small puncture [00:28:00] wound to put the canula through.

When I first started using PRP, I tried to use it like Juvederm, where I tried to lay down retrograde, or a line, do linear lines, or I would do little fans, like you do with a [hyaluronic acid filler 00:28:21]. Imagine if you had a bucket of water, and you’re trying to cover the floor with it. You wouldn’t feel inclined, or need to do that at all. You just pour it, and it would spread. I [00:28:30] found that that’s really what you can do with PRP. Instead of having to retrograde a line of hyaluronic acid filler, for example. Through the tear trough, you can just make a little puncture wound, and my needle doesn’t pass any further than it needs to go to put the lumen all the way through the dermis.

Then, I inject and it hydrodissects everywhere it needs to go, which is what you would have to do. You would have to make that same hole to put a cannula through, so there becomes no need for the cannula, which is why I don’t use [00:29:00] them for PRP.

Let’s read this question. Two questions. What are your thoughts for using cannulas for PRP. That’s it. When I talked about hyaluronic acids, I realize there’s a different reason for using them, and what I see there is our providers are probably divided in half. About half use them and half don’t. I usually don’t, just because I trained without them, and usually do not bruise people, or worry about necrosis, [00:29:30] because I’ve trained learning how to do it with a regular needle. But, I don’t have any problem at all with using them. I think that people who like using them should keep using them.

Next question. As well, I have a patient with very mild acne pitting, with slightly darker skin. Do I set my speed faster and depth deeper with microneedling? How many treatments, and expectations?

So, I talked with a guy who actually invented one of [00:30:00] the pens, one of the major name brands. He said that-

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Section 4 of 5 [00:30:00 – 00:40:04](NOTE: speaker names may be different in each section)

Charles Runels: The pens, one of the major names brands. And he said that they found that more holes is always better. And the only reasons they put three speeds on the pen is because they knew if they only put one speed, that others would brag about how they had a three speed pen and his company only had a one speed pen.

To me, it’s similar to your blender. You know, there’s a frappe and a whoope and a soupe and I don’t even know. Those 16 button blenders, is there really a difference between [00:30:30] button 10 and button 12? I just don’t have one, I have a blender that has one switch, on and off, and it’s got a steel bar that connects to the whirling blades. I think you could grind nails with it. When I turn it on it’s just wide open or it’s off. Maybe, it has a low, I don’t know, but it’s just one switch.

That’s the way I would think about your microneedling device. Just, turn it as fast as it will go [00:31:00] and as far as the depth goes, I don’t think it relates so much to the color of the skin. As a matter of fact, one of our providers, Dr. Lubin, up in New York, is treating and has some really beautiful pictures where she’s treating keloid in dark skin, with microneedling. I don’t think that really matters. I think that what matters is that you look at what you’re doing and you vary the depth, such that you’re getting [inaudible 00:31:29] hemorrhaging [00:31:30] as in going all the way through the dermis.

As far as expectations and how many treatments for someone with acne, I would plan on doing a series of three, about four to six weeks apart. The other little pearl of this is that, I would go ahead, even though it may not be part of what they came for and even though it may be a younger person, consider adding some volume to the cheeks and wherever it might need it using Juvederm or hyaluronic acid filler because adding [00:32:00] volume before you even treat the pit, pitting acne, is going to make those pits more shallow, just like if you blew up a basketball, the little holes are going to become more shallow because of inflation. Before you even directly treat the acne scars, they become more shallow, just because you add volume. And the expectations would be, I never tell anybody that things will go away but just that they will be improved and you can promise them, that they will be improved. They will like it and it will be softer [00:32:30] and less noticeable after you are finished.

All right, I think let me slow down here, because we’ve got some people commenting. I’ll start at the top and we’ll start with Dr. Kelly. I think I’m just going to unmute, Dr. Kelly, if you don’t mind. Let’s just let you ask your question to the group in a second if I can get this done. Here we go.

So Dr. Kelly is gynecologist out of the Atlanta area. She one of the, way back in the day came to see me [00:33:00] early on and trusted me. Has been doing the procedures for quite a while. I’m glad you’re able to log in. Tell us how it’s going and what’s the question.

Linda Kelly: Things are going well. Thank you very much. Can you hear me?

Charles Runels: Very well.

Linda Kelly: Okay. I had a question about whether or not anyone has used PRP in other areas of the body such as in the buttocks or a lift in that area, along with sort of like a vampire butt lift. Used it for cellulite [00:33:30] or anything. I just wanted to hear from the other doctors.

Charles Runels: I’ll see if anyone raises their hand and I’ll post this on to the websites. As you might know, we’ve talked about this before and I’m glad you brought it up so we can see what other people say about it. But, I normally will treat the lower part of the buttocks, that will roll right above the leg, like a Vampire breast lift and try to put at least 10 or 15 ccs preferably 15 mls of [00:34:00] PRP on each side and that fluffs that out where it’s rounder and I’ve treated quite a few people who’ve had divots in their buttocks from a cortisone injection and I don’t even mean Juvederm. If you just put 5 ccs of PRP in that, somehow it just knows to fill in and it won’t overfill and it looks beautiful and it’s permanent. I have people that, one of the first things I ever did with PRP, on the very first day, someone came. I put it in, not knowing if it would work, it worked great. There’s a lady on my staff, that’s been with me for several [00:34:30] years, same thing, just injected PRP in that area so the fat in the buttocks, just like in the breast, goes crazy with PRP. But somehow, it knows what level to go to genetically and it doesn’t overfill or underfill.

But, I don’t see anybody else raising their hand. I’ll post this to the website, Linda and see if anybody else comments on it. I know for the, I’ve had quite a few people, I don’t think any of us are doing this yet, but I’ve had quite a [00:35:00] few people tell me and they always just start ranting about the results from microneedling in post partum stretch marks on the abdomen. I know being a gynecologist, you probably have a few of those ladies around and they just rant over and over again about how wonderful that works, microneedling with PRP for stretch marks.

I’m just going to leave you unmuted, because I know you’ve been doing this for a while and might help us with some of these other questions. Would you have any, if someone was [00:35:30] just starting out, when you started out, our marketing, we didn’t have this much attention, nothing like this much attention when you first come to see me down in Fair Hope, so any tips you would give them as far as what you did right in marketing and maybe where things didn’t work so well. I’ve never even asked you this question before, but I was [inaudible 00:35:53] anything that you would say about what work well for you, what maybe did not work so well with you work.

Linda Kelly: I [00:36:00] really do think, with someone who is a celebrity, has had an experience with the procedure that piggy backing off of that, it makes a huge difference. People were interested in that and it, there were people who did not like the name Vampire Face Lift, here in Georgia, but there are people who loved it, so it’s kind of a different clientele that we were attracted to the practice because of adding that. Everyone loves the microneedling with PRP, I [00:36:30] mean, it’s really just, it’s been amazing and it’s one of the most popular procedures at my office, now.

Charles Runels: Beautiful. It’s interesting, it’s become accepted but you’ve been with me long enough to remember, when we first started using that name, and you don’t hear it so much now, now we spend lawyer money trying to shut down the people who are stealing it from us, but eight years ago when we first started using that name, we got a lot of criticism about how gross it was, it wasn’t really a face life, [00:37:00] but of course it is a face lift, in some ways more true than a surgical face lift, in that we are lifting the skin away from the skull and recreating that younger, full shape.

Of course, I’m all for surgery, I have great, we have amazing plastic surgeons at our groups. I want to make sure I say, someone goes through a windshield, we can put their face back together, that’s wizardry. We have amazing plastic surgeons. But there is this war for what [00:37:30] a word means, right? Like what does vas rejuvenation mean, some people want that to mean just surgery, and some people don’t want us to use it at all. There was this war, they thought the vampire name was gross and they thought we didn’t deserve to be able to use the face lift name, so you had enough courage to come on early and I’m grateful for that.

Let me see who else is on the call. Here’s a question from Rob Hamilton. If you don’t mind, [00:38:00] I gonna unmute you, too, Rob and see hold on a second and see if you can just ask the question. Go for it. Can you hear me, Rob? Are you there? There you are, now we can hear you. Go ahead and ask your question.

Speaker 3: Did you want some coffee or anything?

Charles Runels: Are [00:38:30] you there?

Speaker 4: Is there any way around here to get a bowl of soup?

Charles Runels: Okay, I’m just going to mute him. He must not be able to hear me. Okay here’s his question. He says I’ve done two hair restorations procedures and the patient said the intradermal injections both the vitamin and the PRP were very painful. I tried scalp blocks but didn’t have much success. We had tried putting the cream on also, again still painful. [00:39:00] Any hint, tips, experience for better pain control during this procedure. Sorry, I may not be able to stay on the line, okay.

So yes, I get that a lot that the hair is painful and so I’ve seen many ways, at least half a dozen ways to block the scalp and I’m overdue to do that. I’m just gonna promise you I will do that. I teach it in my hands on classes. [00:39:30] The method I have found works the best for me, at least in my hands and the short description would be though is I’d take 10 millimeters of 2% lidocaine and I usually just use it without epinephrin and I make little blebs just below the hair line as though I were making a line across the forehead, like you had a headband on. I do that across the front and then I do two injections in the back [00:40:00] that I’ll demonstrate on video, each of them two and a half ccs.

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Section 5 of 5 [00:40:00 – 00:50:55](NOTE: speaker names may be different in each section)

Speaker 1: And i”ll demonstrate on video each of them two and a half CC’s a piece and that gives me good pain control. That’s the first thing. And it usually gives me wonderful pain control but hardly ever perfect.

Then the second thing I do is I divide the PRP into one CC syringes with a Luer Lock. One CC syringes with a Luer Lock and I put 30 gauge half inch needles on there. The significance of that is that the 30 gauge needle doesn’t hurt much, but [00:40:30] if you put that 30 gauge half inch on a five of a 10 CC syringe, it takes forever to push the PRP out because the hydraulics all off. But if you it in a one CC syringe without a Luer Lock you just blow the needle off the end of it and you just give the person a PRP shower.

So it has to be a Luer Locked, one CC syringe and then the hydraulics are that you can push that very, very quickly. And so you can do the scalp literally [00:41:00] in about a minute or less. Where … So even if you have, say you have three out of 10 pain, if it takes you forever to do it, after you’ve done a bunch of injections, they’re not liking it. But you can get a six out 10 pain and if you can be done in 30 seconds, 45 seconds, they’ll still think it was pretty good because you’re just over before they have the time to complain much.

So those two things, the block combined with using that setup allows me go very quickly and so I owe you a good video to show [00:41:30] you how I do my block. And again, I have the great privilege, I think, to have taught these classes now for eight years and seeing how the people who come to me to learn the face, who are already making a fortune doing hair, see how they do the block. People come to me who are a very expert and every class I teach I try to learn something. So, it puts me in a very, I think … I’m just very blessed to be able to learn from you guys. So I’ll take [00:42:00] my combination best block and put a video up. But swap to the one CC syringes with a half inch 30 gauge.

Okay. So here’s another one from Dr. Newbanks. That’s a good tip. So I’m gonna let you tell them that. I’m gonna see if you can … Hopefully I can get you on here. Dr. Newbanks has been with us awhile. Let’s see if I can get you on.

[00:42:30] You there, Desmond?

Yeah. There you are. Beautiful. So give us your pearl about hair. Nice to hear from you.

Desmond: Oh. Yeah. Good to hear from you.

Well, what i do with hair, I have a little magnifier, dermatoscope, that attaches to my iPhone and so I can look under pretty high magnification of the scalp and there are areas that look full but they’re actually very wispy hair. And that helps me to be a little more precise with my injections. [00:43:00] And I combine PRP with an amnion called BioDRestore and get really good results. And the results tend to last … Oh, a year and a half.

Speaker 1: Beautiful. So you’re … Appreciate that tip. So where did you get the magnifier that’s attached to your iPhone?

Desmond: Well, it’s made by a company called Canfield. And it’s the brand is B-E-O-S H-D-2.

Speaker 1: [00:43:30] B-E-O-S H … as in hat, D as in dog, 2?

Desmond: Correct.

Speaker 1: Okay. I’m gonna put that in the chat box. Thank you for that top. Let’s see.

Desmond: Welcome.

Speaker 1: B-E-O-S H-D-2. And it’s called Canfield with a C right?

Desmond: Canfield with a C is the manufacturer.

Speaker 1: Okay. Great tip. Okay.

And then, there was something else I was gonna … Oh. For your [00:44:00] amnion, I’m pretty sure the BioD people get their amnion from our new supplier so you might wanna look at the price on the website. If you go … I think I just showed you where to get to it. If you go to the Vampire Face website or member website. And then you click over to the Vampire … Look under the recent posts under Vampire Hand Lift and then you scroll down. That’s it. That’s the telogen. [inaudible 00:44:28] supplies. [00:44:30] Excuse me. Telogen, you can see it there in my little video, supplies entheogen or the amnion entheogen plus this is the amnion. And we’re getting 25 milligrams for a price that’s probably about a third … I bet it’s no more than a half of what you’re paying to the BioD. So hopefully that’ll help you.

And by the way, that price is only on our membership site. It was part of the deal I cut with them. I don’t have it out there. It’s only for our members. They just figured they [inaudible 00:45:00] [00:45:00] for it with volume because our people are, or they knew how to market and how to take care of people. So, might check it out.

But that’s a good tip. So, did you try it? Did you do the scalp without the amnion and swap over. What caused you to swap to the amnion? What happened there?

Desmond: Well, I just started using the amnion. The guys that I’m training with down in Boca Raton used the BioDRestore. And that’s why I used the BioDRestore. I started using that. [crosstalk 00:45:29]

Speaker 1: And [00:45:30] you saw a difference in your success rate?

Desmond: No. Again, it’s based on his experience. That prior to him using it, his results were not as good and were not as long lived but after the BioDRestore, there was a substantial difference, or the amnion.

Speaker 1: Beautiful.

Do you know what milligram it is that you buy? I know that the product come in …

Desmond: It comes in a one milligram vials. But these are [crosstalk 00:45:59] [inaudible 00:45:59].

Speaker 1: Oh. [00:46:00] It’s a one milligram vial?

Desmond: It’s a one milligram vial. And it’s frozen. So you gotta have a freezer that can keep it at -30 degrees.

Speaker 1: Not sure what happened. Yeah. Ours is a 25 milligram vial. So, even if … I’m not sure what happened there with your sound. Check … ‘Cause it comes as a powder and it comes reconstituted with a powder and a [00:46:30] sterile saline. And no matter what the volume is, look at the milligrams because we’re getting a 25 milligram and one CC. And we have half of that, we have 12 and a half milligrams and a half CC. And it could be that what we have is quite a bit more for a lot less to help us stay profitable.

So thank you for those. Those are good pearls.

Desmond: Alright.

Speaker 1: Let’s see if we have other questions.

I’m not sure what happened with our sound there, Dr. Newbanks. Hope you forgive me for that.

Desmond: [00:47:00] No worries.

Speaker 1: Okay. So, here’s one from Dr. Pickens. I’m gonna unmute you, Leslie, so you can … Oh, he fell off the call somehow. Okay.

I’m gonna unmute you, Dr. Pickens because it sounds like you might have had some things go wrong. Let’s talk. I mean, nothing serious, but let’s figure this out.

You there, Leslie?

Can you hear me?

[00:47:30] I’m not sure what happened. Can you guys here me?

So, I’m just gonna read this question. I’m not sure how we got disconnected.

Oh. Okay. So Leslie’s still there, but her sound is off.

Okay. So I’m gonna read your question, Leslie. It says, “I’ve done the ‘Vampire Breast Lift’ in patients with small breasts or long pendulous breasts. [00:48:00] You see little change. I’ve even used radioshurperapies. Anyone gotten success with patients with small breasts? If this is to [inaudible 00:48:08] aspects of the breasts with large?”

You know, that is a … That’s tricky. So, heres the thing. With the long pendulous breasts, say where it’s just almost flat and long pendulous, they … It doesn’t work as well. And I often will just, will not do it. I’ll tell them that probably they need [00:48:30] an implant, and I’m just not gonna be able to do much. When I’m talking almost flat, very long pendulous.

For the smaller breasts, I sometimes do get good results, but I have to let them know what’s going to happen. That you’re going to be perkier. So with this, they’ll be fuller, but it’s not going to be necessary cleavage that’s meeting in the center. It’s just going to be perkier like they had the bra on. And this … So this in a smaller [00:49:00] breasted woman who’s 20, may not do so much because they’re already perky. But let’s say she’s 30, and she’s breast fed her baby, then even though I’m still not going to have the breast … The cleavage meeting in the center and maybe not even enough coming towards the center to where she thinks it was a dramatic change. Because her breasts are not as perky perhaps as they were before she breastfed, she’s likely to [00:49:30] still like what I did if I tell her that’s what the goal will be and she’s, knows that up front.

And using that strategy, I do have a lot of ladies who had smaller breasts are happy, but not so much with the long pendulous breasts. So hopefully that answers that question.

So, I think maybe that’s enough. That’s 15 minutes. And I think we covered most of the questions. We did some marketing. Does anybody have anything they wanna add that’s … [00:50:00] Before we close this down because I know there’s some people on the call that are very experienced.

I hope to have some new tips. I’m spending three days and a bunch of money out here in Santa Barbara learning from the best. I’m surrounded not by doctors but by marketing people and programmers. So hopefully we’ll, I’ll have some new tips for you guys that I didn’t have even yesterday by the end of this week that I can put out there.

I continue to be honored. I don’t see anybody raising their hands. So you guys have a good day and [00:50:30] I’ll post this recording. Go check out the amnion and be sure and put up lots of stuff about Vampires this month because … Even if you’re just doing [inaudible 00:50:41] you can say, “Like the Vampire works, here’s how the [inaudible 00:50:46] works.” Use that Vampire word and you’ll be tapping into the flow. You guys have a wonderful day. Bye. Bye.

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Vulvodynia, lichen sclerosus, phimosis, O-Shot®

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