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.
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.
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.
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].
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.
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 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.
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.
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.
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.
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
How to Allow Your Patients to Participate in Our Surveys
Charles Runels: So let’s talk about how to put people, your patients into our surveys. First of all, why would you want to do this? Well, if we intend to advance the science, obviously we need to do more clinical trials. We have two under way, but it will help us design those future trials if we have a lot of survey data. And this is not [double n 00:01:34] placebo controlled study for sure, but there’s nothing to sneeze at when you have, if we have thousands of data points which we could easily do and it’s prospective data.
This could be very helpful in designing our next clinical trials that are double n placebo controlled, so that we’re more likely to get a positive and helpful result or, rule out what’s not helpful. You’ll see our surveys include questions about which PRP kit did you use? We’ll know which specialties we’re doing, how long they’ve been doing it, and open ended questions that might help us discover things we’re not currently aware of.
Also, of course, the fact that you’re participating in the survey indicates to your patients what you are, which is a concerned and thoughtful and science-minded provider, so putting them into the survey, or asking to put them into the survey lets them know that you’re participating in a scientific endeavor. This is again, not double n placebo, but it’s prospective survey data which we can do.
By doing this, we’ll also put an icon by your name. I’ll show you what that would look like so if you go to for example, let’s see, we’ll go to oshot.info and if you click on “find provider,” find certified providers, so when you click on that you’ll see that there’s an icon, a little ribbon that indicates that you are helping us with our research. People who are looking for a provider and they see that, and you can see, this is the legend that indicates to patients what these different things mean. This means you have radio frequency, this means you have laser in your office, this means you want to treat lichen sclerosus and if you want one of these icons by your name, just send us an email and see.
So by putting this little ribbon thing by your name, it indicates that you were putting people in our survey and you can see most of our providers are not. So it would give you a way of distinguishing your practice.
Okay, so hopefully everybody will help us with that. I thought about making it mandatory that everyone help us with that, but I’m hoping that we’ll just voluntarily do this. When you put five people in the survey, then we put that by your name.
So why would you not want to do this? There’s some concern about privacy. I want to show that we use Survey Monkey and Survey Monkey is a very respectable software that allows us to do this double password protected and HIPAA compliant. And then even to put someone in and the other thing is we don’t ask people for their name and we don’t, but we do ask for their initials, the provider’s name and the day they saw that provider.
The provider could backtrack it and figure out who the person was should there be something interesting either positive or negative, the provider could contact that person. But we don’t intend to share that data unless there’s a need. So the person gets a text message and the way you make that legal is, I’ll show you. So here’s how you put people in the survey. You go to, for O-Shot, you go to oshot.info/members and then you log in. Now your log in page will look different than this. I’m coming through the back side, but when you log in, you’ll see … I’ll show you. You’ll be on our directory. And when you get to the dashboard, this is what you should see after you log in.
By the way, pay attention to this, because lots of good information we post updates to everything over here. This is how to do the procedure which most of you have seen. If you have questions, here and here are good places to go post them. But go here for the patient survey. Then, and you could literally give someone on your staff if you wanted, access to this, but try to make it one person so not too many people are logging in. And you have control and accountability of who that person is.
So the other reason you may not want to do this, one is privacy which I’m showing you, to put someone in you have to be able to log in, so when you get here you put this is a little ten minute explanation for how to do it. How to enter people into the survey. Here’s some nice questions that one of our gynecologists had that I thought were thoughtful, so I put a recording of that. And then, this is what you would want, preferably the patient, to enter themselves into your iPhone, with your iPad, so then putting their cell phone number here is what gives you legal permission to text them.
Now, if we put the email in here, that’s helpful for us to contact them, but that email often gets grabbed by spam filters, so we found the best way to survey them is by text message. Then, here’s where we get the up front demographic data that helps us figure out who’s doing best and that sort of thing. You put the provider’s name, how long the provider’s been doing the procedure. It’s all drop down menus. Which PRP kit did you use and did you activate it and with what? And so it’s very quick, less than five minutes. But that’s the other thing. I know five minutes is an eternity when you have people stacked on top of each other waiting to see you and the phone’s ringing with six lines. Understand this can be a nuisance.
Try to set yourself a physical reminder, something that reminds you of the survey in your exam room and, or on the chart, then whenever someone does an O-Shot, fill this out or have your staff fill it out, it’s very quick. Then you’re done.
Then we will collect the survey and I’ll show you what it looks like on the Priapus Shot website in a second. For some reason we’re getting a lot more surveys with O-Shot than for Priapus Shot. But once you do that, then we send them a personal text message and they still don’t fill it out. Their data is not stored on my website, it’s not stored on their phone, it’s not stored on your website, because we don’t want anything being hacked. Their name is not stored anywhere. So to figure out who they are, they would have to crack the code if someone actually somehow managed to crack into this HIPAA compliant website, where it’s stored on Survey Monkey, they still wouldn’t be able to figure out who the person was without cracking their medical records because it’s only listed by initials and date of birth, and date of visit.
So they would have to crack into your medical records, even if they cracked into our survey data to be able to figure out who this person is. So it’s triple-protected, because they have to go through two password-protected websites to get the information and then crack into your medical records to figure out who that person was. So this is very, very triple HIPAA compliant survey.
They get a text message and then that takes them to the female sexual distress scale and open ended questions on the female side and erectile dysfunction scale and open ended questions on the male side. So here’s what it looks like on the Priapus Shot side. So when you log in, you’ll be looking at this, you go to patient survey and then there’s the instructions. Again you have the patient fill this out, have them put their own cell phone number into your iPhone, your iPad or whoever you’re collecting that data and then that tells them you’ll be sending them a text message. Make sure they know that their data, how privately it’s protected, then again did they sign a consent form? And some basic demographic data which PRP kit did you use?
This is the only thing that might take a little time, put what medications they’re on, from testosterone are they seeing a sex therapist, things that will help us determine what variables might make our shot, because sometimes this procedure is crazy, crazy, crazy effective and sometime it isn’t. So, part of the challenge is to decide how to make the procedure better and another part of the challenge is to decide how to better choose the people for whom this procedure will help and those it will not.
I hope you’ll participate. Again, if you do this, we put that little icon by your name so that people can identify you as someone participating in our research and try to reward you with more phone calls. I hope this is helpful. Please contact us if we can help you further.
Charles Runels: I thought it may be helpful to start offering suggestions about what I’m reading, and what others in the group are reading and writing, so that our weekly meetings become not just sharing our procedures but approach being something like a journal club or a reading club, book club. That’s why you see what’s here on the screen now. I just got this in the mail. I bought it before it was published. It just came today, so I’m extremely pleased with this. The reason I’m so interested in centrofacial rejuvenation is something if you know, if you’ve attended my class. That is the most important part to improving … It’s the number one place to improve the appearance of going back in time in appearing younger. It’s the eye to the mid-cheek.
Some of the procedures in here are surgical. Chapter eight has some beautiful diagrams offering midface volumization with fillers. It talks about the anatomy, and highly recommend this book. I’m putting a link to it in the chat box, and I’ll put a link to it on the page where I put the recording, but very well done. Other chapters are helpful in [inaudible 00:01:53] videos. Part of what brought this up is I had a question today. I had some cosmetic questions. Let me pull those up. Then I’ll field questions from you guys. I copied this out of a email that came to me. Number one, “Why use none activated platelet-rich plasma on the face? Can we use activated prp and when?” Again I’m going to put it here and recommend that you guys check it out. This question, I’ll cover it again because it’s helpful.
Finding the Answer to Questions
If you go to Cellular Medicine, actually I want to just show you where a lot of these questions live. I’m happy to go over it, but if you have a way to search and find it very quickly without waiting for me to answer, then that would be a better thing. Some of you guys don’t know how easy it is. If you go to CellularMedicineAssociation.org, and you just put in the search box right here, so you can say activation. Hopefully, I’ve got that in there somewhere. There you go, so it’s like an index. I don’t have something that says index but it will pull up … Because I’m having all these transcribed, it will pull up any transcription that has that word in there, and so that’s a good way to search for things.
You could also go to the membership sites, so if you went to VampireFacelift.com into the member section, and this is the backside so you wouldn’t see this. You would land on, I’ll show you. You would land on the dashboard, so it would look like this right here. Then see where it says, “Post,” you could just click and you post. There should be a search box. I guess there’s not. I need to put one on this one. Most of the membership sites have the search box, so my bad. I’ll put one there. You could also go through here and look at just there’s the titles, recent comments, and there’s key words. This one needs a search box. Anyway, that’s the two places to look on our main website, the Cellular Medicine Association.
Looking at recent posts, and you’ll get the most recent stuff, but on the membership sites, the other place to look, it’s just look under the directory. I mean go to the dashboard, and then look under webinars. There’s the dashboard. No, not taking you back. Anyway, that first dashboard where we were at, it’s a directory, workshops, forums, and then there’s a page for webinars. Then at the bottom of every page there’s a question and answer session. You can see there’s a place to post it, so go in there. The good thing about doing that is you get answers from other people, not just from meif you do that. There’s one about calcium chloride. “Does it help? When do I use it?” Then you can see well, here’s the answer and it takes you to a recording from one of our webinars.
Activation or Not Activation of PRP?
I like doing it that way because it makes sure, it give everybody a chance to contribute, so it quits being about Charles. I’ve been fortunate enough to play around with plasma for eight or nine years, but newer people in our group are also doing that and have different expertise so it’s helpful. Here’s the answer to the question of why use nonactivated platelet-rich plasma. The reason for not activating it is the calcium makes it hurt more. Calcium chloride just hurts. The other reason to not use it as in activate the plasma is that you do get around 65% activation without activating it because when you put the plasma, inject it into the tissue, the exposure of the platelets to the collagen of the tissue itself activates it as it would in a normal [inaudible 00:06:47] if you had an injury and the platelets come outside the body, it activates the [Thorman 00:06:51] cascade, exactly the same thing.
You get 65% activation if you just take the inactive platelets in the syringe and inject it subdermally or intramally, and it doesn’t hurt as much. It seems to work well enough for the hair and the face. Most people are not activating. The reason we changed that and activate with the [Priapus 00:07:16] Shot, and with the O-Shot, and with when we’re trying to regrow nerve as with decreased sensation in the areola of the nipple, is because we’re thinking that because it’s more therapeutic type effect, and because we’re trying to maintain the material in a smaller space. Geographically we want it to stay close to the urethro so in a very small area the calcium makes it activate more quickly and more thoroughly. That’s the reason. No one can fault you for activating it with the face as well. It’s just a cop out to make it not hurt as much.
Can you “use prp in the vaginal lining?”
Number two, “Can you use prp in the vaginal lining?” I have used it everywhere, and I see one of our gynecologists is on the call, so I may get Kathleen Posey to comment on this too. Can you use prp in the vaginal lining? You can pretty much use it everywhere as best I can tell. I can’t find any ill effects except in one case where it was injected into the eyeball trying to do something with the retina, so don’t give anybody a shot in the eyeball. Otherwise, I have injected circumferentially. I’ve injected in the labia minora, the labia majora, posteriorly. Anecdotally, we’ve had two people in our group see help with rectal incontinence in a severe postpartum tear. That was years out and still saw some improvement in rectal incontinence. We’re using it all over.
The only reason I quit putting it completely around the vagina circumferentially is that in the beginning it was so costly I was trying to avoid injecting more places than needed because it cost us so much to make the plasma. I found, so 80/20 rule, I could get actually all the results I needed by just injecting around the clitoris and along the anterior vaginal wall thinking that’s where a lot of the sensation is as in Grafenberg, not just the spot but the whole urethra being sensitive, the Skene’s glands, that’s where a lot of the sensation takes place. It’s also up there near the inner part of the clitoris and all the nerves [inaudible 00:09:45], just a lot of magic happens there.
Not so much the anterior vaginal wall, there’s not that much lining there. I mean, excuse me, there’s not that much sensation there. Having said that, I’m going to see what Dr. Posey has to add to that. Then we’ll get back to the face, the best way to treat nasolabial …
Charles R.: … that and then we’ll get back to the face, the best way to treat nasolabial folds. So if you don’t mind, I’m going to unmute you, Kathleen, and see because I know you’ve done a lot of these. Are you able to talk, Kathleen? Are you there? You may not have a-
Kathleen P.: Yes. Hi. Hi.
Charles R.: Good to hear from you.
Kathleen P.: Hi. You too. I have injected it there not a lot [inaudible 00:10:26] end up with some left over, I’ll inject it in the labia minora, the labia majora. And it just depends, if they’re having pain in that area, I’ve definitely used it a fair amount and it does help decrease the pain.
Charles R.: In the lateral vaginal wall, you mean?
Kathleen P.: I have a little-
Charles R.: He didn’t really say vaginal. He just says vaginal lining, doesn’t he? I’m sorry. Go ahead.
Kathleen P.: Yes some … Yeah. I’m more doing it in the posterior vagina. I don’t know if it hurts sticking it in lateral because the vessels and stuff. I worry about hematoma. I wouldn’t go too deep if I were to inject it there.
Where to go to create an “interview video” for your website
Charles R.: Okay. You know what? While it’s on my mind, if you will do this, Kathleen. And I’m going to put it here so others may want to. If you go … so far I’ve only done this with three, excuse me, two of our providers, but I’ve never made it public. I’m trying to make it … I’ll show you what I’m doing. If you go to the O-Shot® website and you on the … over here on the recent posts, you can see I’ve talked to Dr. Goodman about some of his surgical techniques and how he thinks about orgasm and how the different procedures he’s using and I’ve just recorded it and put it there for patients and doctors to learn from. There’s nothing … becomes a very good explanation of the surgeries for potential patients as well.
So back to … oh, you can’t see it. [inaudible 00:12:04] where you can see what I’m talking about. There. So this is a post on the O-Shot® website and it just comes in recent posts and I’ve done that … I’ve set it up to do with [inaudible 00:12:21] and we had some … we weren’t able to record it well and I’ve done it with another one of our providers, but I’m going to put here … it’s so hard. Everybody’s schedule is so busy, but any physician who has … who wants to be interviewed, I see it as a great way to … cellular … let’s see … it’s a great way to get the word out about what we’re able to do and, just as importantly, what we cannot do and how we’re thinking about the science. And here’s where to set that up…
So I’ll show you what happens when you set that up and where to go. So if you take that and put it into … and I’m hoping you’ll set this up, Kathleen, so I can interview you because you got so … I’ll pick your brain a little bit at a time when we do these webinars, but you got so much information about lichen and the other stuff.
Okay so if I put that in there, it takes you here and then if you go to 30 minute phone meeting, book that, and we may actually be on the phone longer than that but just … and you can see you can just click that and pick a day and that fits your schedule and then I’ll record it. You don’t have to have PowerPoint slides. You can if you want, but any doctor in our group who feels like they have a message they want to deliver that would be helpful to doctors and/or patients. I like the interview format because it gives me a way to showcase our physicians and, because I’m seeing a lot of the questions that come by email and such, it gives me a way to get a more balanced answer to these questions rather than me doing all the talking, which is just not the way it should be. Okay, let me get back to these questions. So if … I’m going to put that in the chat box too and, hopefully, you’ll set that up, Kathleen. So anybody else can call because you got so much … how many years have you been doing this now? Three? Four?
Kathleen P.: About four.
Charles R.: I know no one … I don’t know anyone who’s inject … who’s treated more people with lichen sclerosus [using the O-Shot®] and you’ve got a strong surgical background too, as strong as it comes so let’s set that up. I’m overdue to do that. Okay, so back on topic. I’m just going to leave your mic unmuted there, Kathleen, and get back to finishing these questions. Let’s see. Go back to here.
What’s the best way to treat nasolabial folds–PRP, fillers, or threads?
Okay. So now for a face question. What’s the best way to treat nasolabial folds? With therapy or threading or with filler? I think this one is … let me pull up a picture. Let’s see if I … I think a picture would answer it better. Let me find a picture I have permission to use. Because this is definitely a case a picture’s worth way more than me babbling on and on.
Okay, here. So if this is the problem that you’re trying to make go away, the question was: is it better to use fillers or plasma or some sort of thread lift or surgery? There’s lots of different things. What can you do for that? So the main principal I follow is that this cheek area is more important than whether there’s a line present here or not. You’ll see nasolabial folds in children, but this is not necessarily an age line. It become a sign of age, when relative to the rest of the face, when you see that this … let’s see if I can draw on this. Let’s see what I can draw. Good. Okay. So when there’s a stripe, there’s a heavy strip, you can see it kind of goes like that there, with this being flat over here. And when you see that, it’s not the line that’s making people look older and you can kind of see the appreciation of a line right there, but not so much visible there sort of like a dash line. There’s definitely a line there under the eyes and then there’s this line and then this looks relatively flat. When you see that, that’s a person for whom either fillers or platelet-rich plasma is going to help.
If I’m trying to decide which will be appropriate, then I go by how much volume loss is there. If there’s quite a bit of volume loss here, the chances that I will maintain … the shape will look beautiful if I just fill it up with plasma, but the chances that I can maintain that shape become less good than if there’s a lot of volume loss here. If it’s someone who’s never had anything done and they’re … if you’re looking for numbers, if they’ve never had anything done and they’re 40 and up, then they’re probably going to need some fillers there, especially if they have a thin face. If they’ve got a full face and they’re younger or even if they’re over 40 or 50 and they have a full face, sometimes you can get by with the plasma alone. But the bottom line is that adding volume here is going to pull this up and round it out so there’s not a heavy stripe here. And then even if you have a line here, it’s going to be less distracting and not really age causing.
And so that’s kind of how I judge it. So I either use plasma plus prp if they can afford it and they have a fair amount of volume loss or if they’re … if I use prp alone, it’s usually in someone where the volume’s pretty close to where it needs to be and they kind of just want to be fluffed up and usually that’s … they’re 35 or under or they’ve had some work done already or their face is already full just because of their body weight. So most of the time, I’m using both. As far as the threads go, if you do the threads, I would still consider doing this because now you’re doing something similar to a surgical “facelift” but relative to the bone, even though you’re pulling this fold out, you’re pulling the tissue close.
Charles Runels: Even though you’re pulling this fold out, you’re pulling the tissue closer to the bone. You’re really collapsing the face relative to the bone and though the line looks better, you have some risk of causing skeletization and not that round, full feeling look that’s in a younger face.
In the end, all three, the answer to that question is, they all three work. That’s the way I decide. I would seldom use a thread without using fillers or most of the facial plastic surgeons now, almost all of them, even if they do a surgery and pull the skin back, they’ll do it in culmination with fillers to maintain the shape so you’re not just chasing a line. You’re creating a younger shape. I think that answers that question.
I think there’s another one here. Anybody want to add to that, just click the button and I’ll unmute your mic for you. Let’s see. Let’s get back to that question. I think I answered it, just to be sure I did all that. Yeah. That answers that question.
There’s one in here that some of our callers. That’s a good question. Why do you not have a dashboard similar to the others with supplies and videos with a facelift like the other procedures? It’s just simply because I’m the one that’s doing it. I apologize. I just haven’t done it yet.
What they’re referring to is if you’re on the facelift, the dashboard is not as organized with O-shot and P-shot. It’s all still there, but you just have to look around for it more. I’m actually trying to recruit someone who can help me with the websites. I’m still doing them all myself. I started doing websites in 1998 and I can’t find …
So far, I haven’t found anyone that suits me. They’re either over-qualified because they’re actually writing code, which is what I need or they’re under-qualified and they can’t write it. If anybody knows a good web design person that wants to move to Fairhope, then send them this way.
Treating Bell’s Palsy with the Vampire Facelift®
Let’s see. Any other questions? There was one that popped up on the Vampire website from Dana. Let me pull that one up because I answered it. Here it is. I went ahead and answered it, but let’s cover it here because it was a good question.
Dana says she had a beautiful 56-year-old patient who had general aesthetic questions. This is really important because I’ve never covered this in a webinar, by the way, so I’m so grateful for this question. She said, “She’s not new to injectables, but has not received any kind of treatment for the last six months because she has left-sided Bell’s Palsy.”
“Previous management for her palsy’s included prednisone, anti-virals, acupuncture. Her friends think she’s showing improvement. Although this wasn’t the reason for seeing me, I’m wondering if PRP might help with the Bell’s Palsy. When you search on ClubMed, it appears not only to be safe, but possibly helpful.”
Yes, is the answer to that. I haven’t counted, but I know at least two people, maybe three, that have told me that dramatic improvements. As you know, Bell’s Palsy can come-and-go, so maybe it was just luck of the draw treating a lot of diseases that wax-and-wane, who knows?
I would get a really good consent form because obviously if you’re not treating Bell’s Palsy, if you just gave her a Tootsie roll, it could get better or worse and has nothing to do with your Tootsie roll. In the same way, there’s always a chance it may worsen even though the science indicates it should get better.
I’d get a good consent form, which we have on the websites now that we’ve even enhanced our consent forms. If you haven’t downloaded them lately, download one. We’ve also made an Amnion version. There’s a Vampire facelift and there’s a facelift with Amnion. There’s an O-shot and O-shot with Amnion for those of you who are considering adding that to your procedure.
Should you stop anti-coagulants before doing the P-Shot® or the O-Shot®?
Let’s see if there’s any other. Here’s another question. Any reason to stop anti [inaudible 00:25:46] prior to P-Shot® or O-Shot®? Here, I’d treat this like an injection, not like a surgery. Most people who are on anti-coagulants are on them for serious reasons.
I had an internist mentor who always said, “The most dangerous medicine an internist ever prescribes is Coumadin.” You can make the case with just a baby aspirin itself. The last time I looked, something like 35,000 people per year bleed to death from gastric hemorrhages from aspirin.
They’re dangerous drugs. People are not going to be on them for frivolous reasons. Therefore, I usually just don’t even get into it. I just hold pressure longer. Tell them they have more bruising. The bruising is also PRP. It could enhance the effects. We’re just going to hold pressure and I do all procedures as I normally would.
The only thing with aspirin, if it’s possible for you to stop. I know that’s not the question, it’s anti-coagulants, but if it’s possible to stop aspirin or non-steroidal a week or two before, that’s better because it’s going to interfere with your platelet function.
Platelets have a longer half life than a week, so I wonder sometimes about that time frame, but that seems to be the standard recommendation is to stop for a week before and to stop steroids, if you can. I do the procedures and I hold pressure.
I was going to, if there’s not any other questions. Let’s see.
Kathleen Posey: Actually, Charles, I have a question.
Charles Runels: Go for it.
Kathleen Posey: I wanted to say, I did do one Bell’s Palsy patient. She had tremendous improvement, even after a year. But, my question has to do with …
Charles Runels: Wait a sec. You got beeped out for some reason on the sound. You said she had tremendous improvement and then what came after that?
Kathleen Posey: Even after a year. She had the Bell's Palsy for a year and still had some residual left. It was able to take away the residual palsy, which to me, was amazing.
Charles Runels: Beautiful. I’m glad that Dana asked that question. Thanks for throwing that in. Go ahead. You had a question too?
Treating Interstitial Cystitis with the O-Shot® Procedure
Kathleen Posey: I have a question about interstitial cystitis. What’s been the group’s treatment plan on that and how successful do you think that is? I mean, I’ve done a few, but I’m running about 50/50. I was just wondering. I mean, just do a regular O-shot? I mean, that’s what I’ve been doing.
Then, also, the same patient had an urethral caruncle. I put PRP in there. I actually think it grew, but anyway. I told her to go ahead and have it surgically removed, which the urologist was refusing to do but the pain was so related to that caruncle. I just think it needs to come out. Just wanted to know if you knew anybody else that had experience on the line with UC?
Charles Runels: I think what I’ll do. I’ll tell you what I’ve heard, but I think what I will do after this call, is I, as usual, I will send out an email to let people know the recording is there. I’ll ask for more comments from our urologists and gynecologists who are treating UC.
To tell you what I’m hearing is, I’ve had now three separate … Well, two urologists and one uro-gynecologist call me excitedly to tell me about multiple patients in all three practices, not just one, but multiple patients, who became completely well after many years of suffering with pain.
That doesn’t mean, of course, that everyone they’re treating is getting well. I don’t think the placebo effect on someone who’s tried everything under the sun and can’t get better and finally they get well with your one thing. My guess about it is that it’s multi-factorial and what’s working with us, is those that have …
Charles Runels: … the factorial and what’s working with us is those who have some sort of chronic inflammatory/infectious process going on with the Skene’s glands but I’m completely guessing with that. The others may have something that has to do with the bladder itself that we’re not reaching with our procedure. How we dissect out the subset that responds versus that don’t I don’t know but I keep offering to finance a study and if you want to do that and try to … Let’s try to work up a protocol and get it approved, someone in our group needs to do that study. I’d like it to come from a gynecologist or urogynecologist, which I’m not, so that it’s paid more attention to. To help you with it, I’ll post it and try to drum up more interest and let’s talk to each other about it so I appreciate you bringing that up.
Let’s see what else we got. I think that’s all the questions.
How to Get on Your Local TV News
I always like to do a little marketing tip or two. We’ve had a few people lately … Let’s see, I’m not sure what you guys were looking at, let me get you back looking at the web page. Just one minute. We’ve had people on the news, quite a few lately actually, and along with that one was on a radio show. It’s not always TV news, one was on a radio show yesterday and so two really nice luncheons lately. I thought I would pull them out and tell you guys both how to make this happen in your own town and the advice I give people when they call me and say, “Okay, give me tips about what to say on the news.” Then if you just know it’s here the next time I’m still always happy to talk with you. If you know it’s here the next time you get that call you can go refer to this.
I’ll fix it where you can see what I’m looking at. Here’s one of our doctors, she’s a gynecologist, Dr. Singer, and she’s doing the O-Shot and you can see she’s come out of sometimes with the laser treatment. Now, first I’ll start with how you get on the news itself and maybe I’ll just tie it kind of step-by-step what to do. First I would get the name of the person, just your local news channel. You want to call the news and say, “I’m a local physician and I just want to be available for comments or help any time you’re doing a health story that involves whatever you do.” For Kathleen it would be women’s health. If you’re an anti-aging doctor you could say anything that has to do with aging in men and women, whatever you want to be known for.
Then you say, “May I speak with your health reporter?” Here’s the thing. You would think, well they would laugh at you and say we’re too busy. The truth is it’s very, very hard to come up with news and I can prove it to you. Just watch the news and see how many times one news reporter is interviewing another news reporter, it’s very often. How does that make news if they’re interviewing each other? They are really hard up. How many times do you see one … They call it breaking the story. One news channels breaks a story and then all of them talk about it for the next week. It’s hard to come up with something new and interesting every day. Then when they do a lot of times they need an expert to comment. If they have someone on speed dial, and this is what you tell them.
Get to Know your Local Health Reporter
First you ask to speak to this person and you say you want to make yourself available if she ever has a story and needs a comment on or off the record. You tell her or him that you always answer the phone and then you give them your cell phone number and you tell your staff, “If you ever get a call from this news you want to be told immediately.” They are not to take a message, they are to get you to the phone immediately because if you don’t take the call they’re usually on a really tight schedule and they will call someone else and you’ll miss the chance for … I literally have millions of dollars of free publicity just because. They’ll tell me, “You know, I was going to call so and so.” I just ask them and they’ll say, “Yeah, I was going … My deadline, I’ve got an hour to get this done and if I hadn’t answered I would have just been out of the story.”
Tell Your Staff to be ready
You tell your staff … Make sure they have your short list, you probably have that already. “These are the people you’re to never take a message.” My short list is my children, my parents, my sisters, my attorney, and anything with three letters; the IRS, the FBI, the DEA, anything that has three letters get me to the phone. That includes CBS, ABC, NBC, and any news reporter of any kind, doesn’t matter how big or small, bring me to the phone. Then after you get the news reporter on the phone you just tell them that, make yourself available. Now, if you want to make news, if you want to be on the news for free you try to tie it to the national press and I put … If you go here, I think I’ve got it on here, let’s see.
Tie to National News
If you go to the marketing part of this … Anyway, it’s somewhere on here. There’s a webinar about how to take advantage of the national press and marketing … Let’s see, what is it? Insurance practices, avatar, anyway somewhere on here. You’re right, it’s easier to find the O-Shot but the thing is if they have … Let’s say that the press does a story on some new treatment for incontinence, it could be any treatment. Well, you call them up and you offer to comment on it, on your local station about that treatment. Of course, you’re going to talk about your O-Shot too. I actually changed the Health Department policy in my county after someone had an injury in Atlanta, the swimming pool. They had no Health Department inspection here back in the 90s and I said, “Let’s do a story,” and we did a story about how there was no Health Department inspection. It would not have been a story had there not been a recent death in Atlanta from their dirty swimming pool.
You watch the national news and when something happens nationwide that relates to what you’re doing you call your local channel and you offer to do a story about it. That can include national press about our stuff. When this hit the news recently, this one. This is a local station but we have clearer … When we hit the national press I will send out an email. When the email comes out and says … Let’s see. Back in October we made a Real Magazine Website and plugged in others about the Vampire breast lift. When that happened you could have called your local TV station and say, “Hey, the Vampire breast lift was just on [inaudible 00:37:53] website or Allure,” whichever one you want to mention or both, “And if you want to do a story about that I do that procedure here in our city.” Then they will interview you often because you have a local comment about a national matter so that’s how you get in.
Getting Ready to be on the News
Now when it’s time to talk how do you get ready to actually be on the news? Here’s some quick tips and you’ll know where this is. It also applies if you’re just going to be, say, giving us a talking somewhere, and it helps you plan the talk. Here’s the tips on that and I think I’ll type them out for you. Let me pull this up because it’s simple but it’s really helpful. I’ve been on the news more than I like to think about in different countries, in Serbia and London and New York. Anyway, the bottom line is this is the process I go through before I’m going to be interviewed.
I first think about … I imagine not everybody in TV land, not everyone. I imagine one person that I love and I pretend that person is watching and I forget everybody else. If it has to do with men’s health I imagine my son’s watching. If it has to do with women’s health I imagine my mother or a woman that I love and I pretend like that’s the only person and that person is on the other side of the television. That couch is my language so that I don’t sound salesy, I don’t sound anything except sincere and engaged and eager to communicate what the message is. That gets the frame … That is so important and I’m not just saying this. This isn’t something I’m just talking about, I literally do that every time I’m in front of a camera or a microphone if you’re being interviewed by the radio. I was interviewed on Shade 45, which is, it’s a rapper station.
That’s the only time I’ve ever been interviewed where I was the most conservative person in the room. They were talking to me about orgasm and it was a call in station and so it was pretty interesting. It didn’t matter, I was still imagining not talking to everybody out there, being interviewed by radio stations in South America where they have a translator or in Columbia, Mexico. Every time I just think of one person that I love and it’s the only person that matters. Then how do you, what about the content, what do you have in front of you? I think about the problem that my thing is going to solve and I imagine that person with the problem.
Let’s say I do a talk about the O-Shot, then I’m thinking about incontinence or orgasm or whatever it is that is to be the expected topic. Then, and quit speaking about me trying to be pretty or smart or say all the right things, it just becomes about me trying to communicate to that one person I love on the other side of the camera. I know this is all a mind game but it works and it’s the reason you’re there or you just go home. We’re here to solve problems for people and so, not to try to be pretty, they got movie stars that do a lot better job of that than I do, be funny or entertaining. I’m a physician, I’m there to teach people how to solve health problems so that’s the mind frame you get and I forget about the rest of it.
Then I think, and this one’s key I think. I think of key words and phrases that I think would be helpful. Let’s say that … And I write this down and then look at them before I go on camera. Let’s say if it were O-Shot I might think, I would think of the words O-Shot, I might think of the words relationship, relationships healed. I might say psychological pain, you get the point? I would make a list of all the friend … I would day provider group, that’s protected, be careful about seeing someone outside the group. Two and three word phrases that I would want to try and weave into my conversation and realize, no matter what they ask. Ask me about the weather. You say, “Well, is it hot outside?” I would say, “You know, it’s unusually cool down in Florida today, which is exactly what happens to relationships when sex doesn’t work.”
Ask me what color my car is. It’s black. “You know, that’s exactly the mentality people have. They have a black, depressed mood when they don’t get sexual relationship fulfillments in their marriage.” My point is, no matter what they ask you you can weave these phrases into the conversation if you have them in your head before you go on. Then I always thank the person, usually I’ll thank them up front for … It’s not a long thank you, it’s a … Because people get bored by, “Thank you so much for having me.” Nobody wants to hear that crap. What I would say is, “Thank you for being brave enough to talk about sexuality on your show because many people are afraid of that and we know how important this is for relationships.”
You throw little kudos to the host for being brave enough to talk about uncomfortable things and they always like it obviously because they can’t brag on themselves. Then it sets the tone and they know their viewers are looking up to them with a little more respect because of something you said. That’s kind of my, that’s my … Then oh, last thing is you want to invite them to do something; contact you, you want to make sure you have the website because here’s the other thing, here’s the bad, I’ll show you the bad news. Here’s the bad news. If you don’t do … This will go away in about 24-48 hours unless you post the recording. Anyone [inaudible 00:44:51] her TV show. It was good for a boost, it lasted less than a week.
The doctor show will last less than two days. A good news report, and I’m watching the traffic on a website. A good news channel … Actually, sometimes the doctor show you can’t even see the blip because a lot of people aren’t watching daytime TV but a good, very populated website will last two, three days and then it’s gone away so why be on the news if it only gives you traffic for 2-3 days? Once you have it then you take these videos like this and you post them on your website. You see where it says … Oh, I had a link copy. Anyway, there’s a way to actually embed this onto your website and hopefully Dr. Singer has that.
Now, every time a patient on the website that says, “Oh, this lady is [inaudible 00:45:47] enough to be on the news,” and then they hear her explain it in an engaging way with her news interview and it just sits there and educates patients day after day, year after year. Then, that’s when you get some traction and that’s really when you go on the news. It’s not you get a little grip. If that was all you got, honestly, I don’t know if I’d waste my time. That footprint that stays out there and gets showed by all of us on the website, that goes … Oh, are you all seeing what I’m seeing? This can be shared and embedded so that that sits on her website and that is what keeps owning on educating people.
I think that’s it unless somebody has more questions. I think we’re going to stop it there, see if there’s any other questions. The take home do for this one, for today’s thing is that we’re going to try to drum up some more talk about the chronic interstitial cystitis because we’re at least three years overdue for doing that study. If you want to get on the news, at least let yourself be known, make introductions to the health reporter in your town. Then when something happens nationwide you can call, they already know who you are, he or she does, and they know to call you if they have a need for a comment. Then there’s the book that I recommended if you’re doing faces for, that’s newly published about the mid-face because I really like the way he talks about that.
Let’s see if there’s any other questions. Thank you guys, it’s always an honor to have when you spark people interested in what we’re talking about. I’ll post a recording if that’s helpful. Goodbye.
Charles Runels: All right so we’ll get started and we’ll go through questions that have been posted on the various websites.
Let’s start with the vampire facelift. By the way, after we finish these questions, I’m going to go over a very quick and easy way to create an email that your patients will love to receive and it will help them both attach to you and want to come see you for the things that you do that will help them. We’ll do that after we cover some of these questions.
We’re on the Vampire Facelift® website. “Hello, does calcium chloride help create better results with vampire hair? Also do you have a contact we can order from? Finally, how much do you mix with the PRP and do you just draw the PRP into a syringe and then draw the calcium chloride up after it, and has it been injected with mix or do you mix it differently?”
I just posted an answer to the activation question. If you go to our company website, cellularmedicineassociation.org, and then you look down here where it says, Questions and Answers activate, and I spent some time right here talking about the different reasons you should and shouldn’t activate, and when you do and you don’t, versus hair versus face, O-shot and P-shot and such. So it’s all right there.
As far as mixing it goes, I like to use a stock bottle so if you have, if you already have plasma in the syringe and you take that syringe and you put a needle on it and you stick the needle into your stock bottle, of course you’ve contaminated your bottle because you put a needle that’s attached to blood on one side in the syringe now into your stock bottle the calcium chloride is in. So I’d pull the calcium chloride out of the stock bottle into a sterile syringe and the pull the PRP up into that syringe that has the calcium chloride in it exactly right when I’m ready to do the procedure because you need to be ready to use it.
Let’s see what else you have. As far as from where can you order it, if you go to our dashboard, you’ll see the dashboard is here. Then if you go to, down here somewhere, it should have where to order everything. Let’s see. That’s all different procedures, ways to do it, well maybe I didn’t put it there so I need to. I get it from Mcguff in California, and I’ll pull it up for you right now. Mcguff compounding pharmacy. There. Mcguffcompoundingpharmacy.com.
So let’s see what other questions we had. On the vampire facelift site. By the way if there are questions from you guys that are attending just push the button and I’ll unmute your mike, the noise gets pretty bad in the background so that’s why I don’t have it unmuted at this point. Lets see, are there frequently asked questions for each procedure that we can use? Where are they located on this site?
So the way I’ve tried to structure … so there’s two sides to the membership sites, or the websites, and they all work the same. There’s one side, so vampirefacelift.com/members, that’s for us. Then vampirefacelift.com with nothing behind it, that’s for the patients. The all have the same format. So there’s O-shot.info, that’s for the patients, there’s oshot.info/members, that is for us.
So when you say frequently asked questions for each procedure that we can use, where are they located, the best place to send people if this is for frequently asked questions by a patient is to send them to the main website. I tried to anticipate the questions. If you look at the number of times this has been edited, you can say, click in here and try to edit the page it will tell you how many times I’ve edited it. It’s probably going to be hundreds of times, we’ll look at it here in a second. But what I do is every time somebody asks a question I try to put it into the website and embed it there so then hopefully they see it. Oh, only 65 times, so of course this is third version of this website but on this particular page only 65 revisions. So those revisions aren’t to make things look pretty, most of the time it’s changing a word, adding a link, you can see there’s a video that needs to be redone. Sometimes something dies. You can see I added a Wikipedia article. I add thins so that every, if someone asks me a question hopefully we anticipate it and hopefully next time they won’t ask that question. So that’s where the frequently asked questions live on the websites.
They’re also put, on most of the websites, on O-Shot®, P-Shot®, I think it’s on the breast lift, you can see I added a review link. Oshot.info/reviews. Here’s a tip right now for getting free advertising, like crazy. I tell people this but still less than a dozen of our providers do it. If you go there to reviews tab, that’s where people ask questions and hen we answer them. Well if you answer a question here, and you can see ,I don’t know I think there’s 300 or so posts or something like that.
So if you go in and you answer, Dr. Posey answered someone’s question right here, then people see that and you can see it links to whenever you answer a question. Whenever you answer a question it links to your profile, so Dr. Seilar answered a question and, from one of the patients, and when you click on it, it takes you to know more about him. There you go, you’re on his website. And when people who go to these pages, they always want to read the reviews, so there’s your way to both find the frequently asked questions and to just throw in a couple of words here and there, taking part of the conversation, and people will see it, they’ll be impressed, and they will come find you. And for some reason, like I said, that’s still very uncommonly done by our people even though it’s a way to get amazing, amazing advertising without really having to do anything as far as money goes.
So here’s another question. Dr. Runels with the current available information, what’s your top PRP harvesting centrifuge in terms of initial cost, for patient cost, ease of use, especially commenting on the clips, insight, [inaudible 00:08:12], TruePRP, they left Harvest out and there are others.
So this technology is changing, the prices are changing and when I look at analysis of the blood itself the numbers are all over the map depending on who paid for the testing. What I can tell you is that I know of failures and, oh they also left region off this list, I know of failures and wild successes with all of the things on that list. My recommendation to you is to get your best price with the best service. If you ask me what’s the best, a Chevrolet or a Ford, I would say that I would never buy a Ford because I had a Ford Pinto when I was 16 and it broke down and so I’m angry at the Ford Motor company since I was 16 years old because they took my money for a lemon. Ford Pinto was the one that would explode when you got hit I the back. But that’s my personal bias, they ripped off a 16 year old boy and I will never forgive them for it.
But maybe you didn’t have that experience, maybe you love Fords, same thing applies to centrifuges. Cut your best deal, all of these kits work, and hopefully our research will show, for example Magellan gives you five times baseline, do you really need that or not? Maybe? Or maybe not. I can give you a more specific thing but it could be out of date by next week so talk to them , cut your best deal.
Let’s see, Thomas asked, do you have any experience using antioxidant serums just afterwards?
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)
Charles Runels: Antioxidant serums just afterwards the Vampire Facelift. The facial or essential oils. I use a HA mist, seems to work well. Sometimes can cause peeling, but not sure if it’s the mist or the facial. What I can tell you, with the facial, whatever you like to use on the face, whether it’s peptide creams … I always like, I’m still an old school 0.1% Retin-A, not Retinol, like Retin-A prescription strength 0.1% cream. Whatever it is that you like, after you do that Vampire Facial, you’ve opened up the skin and you’ve created thousands and thousands of little puncture wounds, so that this material can now be absorbed. So that’s your answer. Whatever you like, use it.
And I find it’s a good time to get people back on a regimen, because they want to protect their investment. It’s like when you check out of Best Buy and they say, “Well do you want the warranty?” Same thing, they’re checking out of their Vampire Facelift, you say, “Well, you really take care of your investment here, and what you’re doing to take care of yourself. We should have you on this, and this, and this.” And I like the Retin-A. And so even if someone has used Retin-A in the past, they may have used it inconsistently, and that motivates them to start using it more consistently.
“Can you give us guidance on hair restoration, and how to know where there are active hair follicles, and where the PRP will work? Is it necessary to do the microneedling?” I don’t think it’s necessary, but I think if you said, “Okay, you have one chance to make this person’s hair grow, and If it doesn’t work we’re going to, I don’t know, run your car off a cliff.” You would probably do everything you know to do, which would include subdermal and microneedling. Doesn’t take that much longer, the cost of goods are reasonable on the expendables for the microneedling device. So I usually do … I do think it’s necessary to do the subdermal, and close behind this on the microneedling, but I always like to do both.
As far as how to know where there’s active hair follicles, you can see where the hair is thin but still present. Obviously you want to treat that. And then there’s this margin where the hair seems to go away. I think it’s worth, if someone has a reasonable hairline, you know, they’re not like a cue ball, if they have a reasonable hairline, I think it’s worth just treating all the way to where the hair line used to be. And I say that because we’ve seen absolutely shocking results in some people where hair grew back where we weren’t expecting it, and others where nothing happened. When I talk to our providers who do hair for a living, they’re hair transplant surgeons, and one guy even wrote textbook on hair … They still can’t tell me how to predict who will respond and who won’t. But the general consensus is to do a series of three, four to six weeks apart. If after the second treatment you see no results, stop, give them their money back, it’s probably not going to work. Thankfully, that’s usually a minority of people.
So, thoughts for using cannulas for PRP. I don’t. And the reason I don’t is when you use a cannula, what do you have to do? You have to make a puncture wound, and then you have to put the cannula through that wound with the idea being now when you extend deeper into the tissue, the cannula avoids further trauma. The thing about PRP, if you’re putting your needle in much further than the puncture wound itself, you’re probably causing unnecessary bruising already, because one of the beauties of PRP that it hydrodissects. You don’t need a needle. For example, with Juvederm, you can’t just inject it and expect it to spread out. It’s going to make a big glob, unless you fan your needle. That’s not so with PRP. You just get the level beneath the dermis and inject, and it just hydrodissects and spreads out as if you were pouring water on the floor. For that reason you don’t need a cannula because when you put the hole through the skin to make the hole for your cannula, that’s as deep as you need to go to inject the PRP, so you don’t really need it. If you like using with a Hyaluronic Acid filler, that’s fine, go for it, but I find it’s about half and half with our providers.
Next question is, “I have a patient with mild acne pitting, with slightly darker skin. Do I set my speed faster and the depth deeper with the microneedling? How many treatments? Expectations?” As far as speed and depth … First of all, with speed. I have a blender that has one switch, on and off, and that’s it. It’s got a steel rod, so I think you can throw nails in there and grind it up. But it has one speed. You’ve seen these blenders that have 16 things: puree, frappe, soupe. How many different words can we use to describe something just spinning around? And it’s bull. Total bull.
I actually talked to the man who invented the Dermapen. And he said they only put three speeds on there because they knew if they didn’t put three speeds, someone else with a pen would brag that they have three speeds. What they found is, as fast as it goes works the best, because you want to make puncture wounds, as many as you can, as fast as you can, to get it over with. So the speed is just whatever you’ve got, plug it in, make sure the battery’s charged if you’re using a battery operated device, and make the depth whatever depth you need to get it to to cause punctate hemorrhaging. Which is going to change, based upon where you are on the face, and whose face your treating.
How many treatments and expectations. Expectations is … That’s like an hour lecture, but as far as if you’re referring to the mild acne itself, then expectations are tremendous. If you do a series of three treatments, six weeks apart, four to six weeks apart, most people are going to love it. So hopefully that answers your question.
Next question, “How do you correct when there is a deep dimple just below the middle of the lip in some patients? Do you use more Juvederm on adjacent sides to get more lift?” A deep dimple just below the middle of the lip in some patients … So, I think I’d need to see a picture, maybe you can post a picture of what you’re thinking about. I hesitate to say much about that without seeing a picture. I will say though, and as a general rule, if someone has a dimple, or a defect, or a pit, or whatever you want to call it, if there’s a place that needs to be filled and it’s deep, as you say here, then I’m probably going to use an HA filler to correct it, and then polish it off with PRP. PRP alone probably won’t work as well, but I guess deep is relative, so to really answer that intelligently I would need to see a photograph.
So I think that’s all of the new questions on the Vampire Facelift, we were a little bit behind on that one. There’s two on the Priapus Shot website. First one says, “I recently attended a Vampire training course in Las Vegas with Dr. Zimmerman, and I had a question about the penis pump. How much pressure? I found that some information says more than 4.5 can damage the penis. I believe that the course recommendation was seven to ten. Do you have any papers that document the most appropriate pressure?” That’s a good question, and I would need to go to the research. The dogma that I’ve heard from urologists and from going on the blogs where the guys … There’s a subculture of people just using penis pumps.
I compare it to what went on back in the ’70s with weight training. I was a teenager in the ’70s and when I went to buy a book on weight training, there was one in the library. And no one knew who Arnold Schwarzenegger was, he was just a weird guy to most people. He was winning these weird contests called Mr. Olympia. And coaches were still telling guys that weight training could make you clumsy. If you go back to the ’60s they recommend to athletes to not lift weights. The point I’m making from all that is there was a subculture. Even physicians came out of this, physicians in the 1980’s
Section 2 of 5 [00:10:00 – 00:20:04]
Section 3 of 5 [00:20:00 – 00:30:04](NOTE: speaker names may be different in each section)
Charles Runels: Even physicians, get a load of this, physicians in the 1980s, late ’80s was the first time that physicians published a paper saying that anabolic steroids actually made you stronger. Up until then, they would say the bodybuilders, that was just water weight. They weren’t really strong. All I have to say, there can be a subculture of people who are basically experimenting on their bodies. You can sometimes be ahead of the physicians about what works, and athletes, especially, are prone to do that. I think, to a certain extent that is happening in the subculture of people who use penis pumps. You can go and find some of those blogs. Like, if you Google, if you Google my name, sovietisms I’ll come up in some of these penis pump blogs. Let’s see if I can find one. If you read the protocols, or following … I’m not saying that’s where we learn how to be … Here we go, the PhalloBoards Penis Enlargement surgery, phalloplasty. This is proboards… phalloplasty.proboards.com. This is all about growing penises. If you go on these blogs, the common dogma seems to be 10 – 20 minutes at a pressure of somewhere seven to ten.
Honestly, I don’t know. I will look at the research and see if I can get you a smarter answer. That’s the number I hear from the urologists and the blogs. More than that, you just create edema, bruising, and you can get damage. Let’s see, what was the other question. All right, let me add to this one other thing that, I know some people use pumps without a pressure gauge. I don’t recommend that because sometimes people, I’ve found, they’ll either pump it up too much, or they will think they’re getting a good pump, and then give them a pump with a gauge on it, they say, “Oh, this is more than 10 [inaudible 00:22:16].” Without that, you really don’t have any objective measurement of what you’re doing. By the way, there was another paper published in The Journal of Sexual Medicine two months ago showing that using a pump, this was in an animal model, we have them with people, but there was another one with an animal model showing that this helps with peyronie’s disease.
Dr. Grow, I have two questions regarding two patients. Patient One, middle-aged man, non-smoker, moderate erectile dysfunction, and he does react to Viagra/Cialis. During intake there seemed to be no psychological etiology. Had a P-Shot two months ago, with [inaudible 00:22:58] PRP, no improvement whatsoever. He said he used the pump daily. So far my patients have always some kind of improvement. This one had none. What is your advice about the P-Shot? Maybe two? What about the cost? Two things I would recommend. First, as far as the cost to the patient, I have … I posted a video about why I always do things for free if they say nothing happened. How I do it, why I do it, but that’s the bottom line. If someone says “Oh, it worked but I want more benefit.” Then I charge them for the next one. If they say “Nothing happened,” then basically, as far as they’re concerned, I stole their money if I stop right there and don’t give their money back, that’s the way I think about it. Maybe it’s not the way you should but it’s what they think. I respect that. As far as I know, anyone who has given me any money, since 2003 when I went to all cash, they either got better and were happy with what it did, or I don’t have their money anymore.
As far as what to do, what else you might do, I do think it’s worth doing this again. I would do it in combination with our whole protocol. If you go to priapusshot.com/peyronies, even though this man doesn’t have peyronie’s disease, the protocol that I put here works for erectile dysfunction as well. For example, using the pump has been shown to help with erectile function. We’ll need less Viagra. Let me add this too. If you go back to think about what we’re doing here, this happened to me once. Someone said “Nothing happened, nothing happened.” So I told my staff and then they delivered that message to me. “Okay, have him come in.” As he was getting on the table to get his repeat Priapus Shot, I said, “Now you’re taking Trimix aren’t you? Have you changed the dose on it?” He said “Yeah, I’ve cut the dose in half.” That’s a win, that is an expected win. If someone’s using Viagra or Cialis, which this man is, it could be that he’s getting the same kind of erection that he did with half the dose of his Viagra or Cialis. That’s the best we can do.
You have to remember to ask them that and also remember to tell them that when you treat them, that we’re not giving you an 18 year old penis, we’re giving you your penis five years ago which is going to be … you’re going to cut your Cialis dose in half or your Trimix, if that’s what you’re using. Anyway, the other things you can do to support it, just like if you had surgery, you have your cholecystectomy and the next day you’re doing LSD, smoking two packs a day and drinking Jack Daniels, you’re probably not going to heal very well. I’m exaggerating obviously but the point I’m making is, there are things you can do to support healing and there are things you can do to interfere with healing. The things that you do that … those things are exactly the things that would support of interfere with platelet rich plasma because we are triggering the healing response.
Here’s the whole protocol for Peyronie’s and for the same thing works for erectile dysfunction. If they’re not on Cialis then I wouldn’t feel the need to start that. But, post prostate surgery and for Peyronie’s disease you might want to because Cialis actually has some biochemical effects that could help prevent the peyronie’s from progressing and cutting off the mechanism might actually help with the reversal of it as well. The research backing all this us is at each link, there’s a video, we’re going to talk about it. You can actually give your people this website, priapus.com/peyronies and suggest that they follow it. I then have sources for them to buy this stuff. On Amazon.
Let’s see, I think there was one more part to that question. I think that’s all that question. Patient number two, who used cocaine and Viagra during his holiday, experienced some kind of pain during sex, ignored it. In the days that followed, sexual sensitivity dropped massively. Urologist and neurologist seen no abnormalities. Neurologist did, actually nothing. The urologist performed an ultrasound. They sent him to a sexology psychotherapist. They could not do anything. According to the patient, there’s no mental cause here, otherwise that, almost never getting erect anymore, which puts a lot of negative pressure on him. The only possibility to get an erection somehow is with tensing his pelvic muscles and straightening his legs. He asked if a P-Shot would help him and how many? I told him I would ask you because of the rapid onset and [inaudible 00:28:40] P-Shot at this kind of onset.
So, if you took out the drug stuff and the story about straightening his legs and tensing his pelvic muscles and standing on one leg and saying three Hail Marys, I would say the next thing I’m about to tell you, I would do. But, with this particular person I would steer clear and just say “I’m not sure if I could help you.” There’s just this red flag feeling when I hear odd things and history of drug use. I’m not saying that this is the most horrible thing and makes people unreliable. Still, cocaine goofs with your ability to have sex. If he’s using cocaine and I give him a P-Shot and six months from now he tells me “My P-Shot’s not working.” Now I have to be the freaking drug police and ask him if he’s still using cocaine. I don’t like to do that. I’ve worked at a drug rehab center, I think I’m good at rehabilitating drug people, very good actually. I don’t like to do it in concert with Priapus Shots. I would want him off of this for a year before I would become his erectile dysfunction-
Section 3 of 5 [00:20:00 – 00:30:04]
Section 4 of 5 [00:30:00 – 00:40:04](NOTE: speaker names may be different in each section)
Charles Runels: Before I would become his erectile dysfunction doctor. But anyway, let’s assume he’s not doing the cocaine and he doesn’t have the story about straightening legs and pelvic muscles and doing three Hail Mary’s to get an erection. In that case, if it were just a history of trauma, and some loss of sensation, I would tell him, lets do two P-Shots, eight weeks apart and not use the pump. For some reason, I’ve found people that have loss of sensation, they do better if you don’t use the pump, if that’s their main thing they’re trying to treat. Not use the pump, two treatments, eight weeks apart and see if he doesn’t get better.
After the second treatment, have him wait a full twelve weeks before we decide if it’s worked or not. So that’s going to be shot, eight weeks, second shot, twelve weeks. So that’s going to be 20 weeks, but these are nerves. They don’t grow like your hair and if you don’t wait that long, you don’t really know what you’ve done so setting that up is to be the deal. I’ll even write it out and have him initial it so he understands what you’re doing. But that’s for people who don’t use cocaine it goofs up your ability to have an erection so I wouldn’t play with it.
O-Shot® with Mid-Urethral Sling
Okay, so those are the two knew ones on Priapus shot. Let’s see there’s … on O-Shot. Here’s the only new one. Dr. Kline said “Can the shot be performed on a patient with a mid-urethral sling in place and if so, does the place of the injection need to be altered or the amount of PRP placed in the urethra?” I actually think, if the shot were done when people do mid-urethral slings, they would probably get better results and more rapid healing. But, we would need someone like Amy Brenner or one of our gynecologists who does slings to tell us the answer to that. I know there was one study done where using the O-Shot in concert with removing mesh gave a really beautiful result and resolved pain. So, the other thing to think about, no matter what the surgery is, say it’s mesh, sling, hysterectomy, all of those things … Well, hysterectomy and mesh, that study’s actually been done. But, one study using PRP with hysterectomy helped healing. I just told you a study taking out mesh helped the pain, helped the healing.
If you’re creating with PRP, something that is normally made with injury to help the healing process, then with any surgery, you can make the argument that using PRP would help the healing process. Therefore, there should be no problem with using it the next day, the next week, the next year. Using PRP should help and there’s no real contra-indication. The only thing is that if I were not the surgeon, I wouldn’t want to be the one doing it post-op until the surgeon released the person and said “Yup, they’re out of the woods, no sign of infection, everything’s working great”, so I don’t get blamed for some post-op complication.
The only other new thing that came up, which I already answered here in words, but the problem is, is amnion stem cells or not? Well, technically, amnionic membrane is a rapidly growing stem cell-like material, but stem cells are alive, or they are just proteins. And the amnion that you’re buying that has been micronized in a syringe or comes as a powder is not living cells. It’s just the amnionic tissue that’s been dehydrated and then Gama radiated and reconstituted so there’s no … Well actually first it’s reconstituted and then Gama radiated, so there’s nothing alive in there. Otherwise you have to worry about catching some disease from the person who contributed the amnion. So there’s no living cells. Now there is [inaudible 00:34:39] who supplies us with the amnion that we sell to our providers as a distributor/wholesaler. They give us a price that’s at the wholesale price. They have a different product that is true, living tissue that is much, much more expensive and it’s not available to us yet. I’m not sure we’ll even need it, but it’s coming. That’s a true living cell. Amnion is not, no matter where you’re getting it.
Now these amino-acid protein chains, or peptide chains, are very, very powerful. That’s the growth hormone, it’s just a peptide chain that codes … You know there’s two types of hormones, there are the steroid-based hormones like testosterone or estrogen that are cholesterol derived. And then there are the peptide chains that are proteins. So that’s why you can’t take insulin by mouth, but you can take [inaudible 00:35:43] by mouth. The acid in your stomach breaks the peptide chains that are in insulin and it just becomes amino acids. As far as your body knows, there’s no difference between eating a hamburger and taking insulin by mouth, because once your body chops all those peptide chains up into individual amino acids, you just have amino acids like in your meal.
But, if you take a steroid like estrogen by mouth, then the acid doesn’t break it apart and it’s absorbed in tact. The point I’m making, is that the peptide chains, even though they’re not alive, they’re very powerful. It’s what’s released from the platelets. So you have peptide chains that are released from platelets, they’re the [inaudible 00:36:35] and all the things that make PRP work. And some of them are exactly the same things made by the pituitary gland, like Somatomedin-C or [inaudible 00:36:41] released from the pituitary gland. Well, growth hormone is released by the pituitary gland and then it causes the tissue in the body, like the liver, to produce Somatomedin-C or [inaudible 00:36:52]. Over two hundred peptide chains are made by the pituitary gland. Over two hundred that we know about so far.
So I think there’s no way to know everything that’s going on when you take these peptide chains from amnion, but what we do know is we have years, much more than with PRP, we have many years of research with amnion showing that these peptide chains have healing properties. I’ve posted some of that research to, I can’t remember which website I put it on now, but I’ll put it here too so it can be found. I think I put it on on the Cellular Medicine, but I recently posted … cellularmedicineassociation.org and then look over the recent post, Amniotic Membrane, Research. So here’s some other papers and actually some of these links open multiple links. So, for example, this one opens multiple papers. Some of these links open ten papers, just with that one link. So that’s some of the relevant research.
Okay. Let’s see what other questions. I think that’s all the new questions on the O-Shot. The Breast Lift, there was one here about sensitivity. “I have a patient that’s had breast implants”, and then after this one I think let’s stop and let me show you a quick, easy way to create an email that’s interesting to your patients and will bring them to you for the things you know how to do. This is one of my hacks, it really kills it. It’s easy, it’s fun, you’ll like it. It makes you smarter. And it brings people to your office.
So, let’s answer this one last question. “I have a patient who had breast implants and has loss of nipple sensitivity. Her primary concern is to regain the sensitivity back. She asks what percentage of people who have received the Vampire Breast Lift do in fact have [inaudible 00:39:03] improvement in sensitivity and are pleased with the results. If you can provide me with an idea of this percentage, that would be helpful.” So, I have had 100% with this. I’ve probably treated, I don’t know, I’ve been doing this fairly regularly for eight years now, and when I’ve surveyed and asked some of our providers on another call what their experience has been, I’ve heard everything from 80% to 90%. I don’t like saying anything is 100%, but for run of the mill, loss of sensitivity for implants or breast feeding, it is very, very, it’s more than 50%, I think is a safe thing to say.
For breast reconstruction post breast cancer, not so good. I don’t even promise them anything. It’s more about aesthetic treatments when I do that.
Section 4 of 5 [00:30:00 – 00:40:04]
Section 5 of 5 [00:40:00 – 00:58:14](NOTE: speaker names may be different in each section)
Charles Runels: Okay. I think I’ll show you my little email hack, and then let’s call it a day. So, let’s say … Here’s the process, let me pull this up for you and we’ll [inaudible 00:40:15]. And I’ll just demonstrate it. This is how to write … This is how to write … an email, very quickly, that you people want to read.
Okay, so I first start with what I want to sell. The market, what am I marketing? In other words, let’s say it’s the O-Shot®, as an example. So, I don’t want everybody to come see me for an O-Shot®. All I want to come see me for the O-Shot® are people that I can really help, like if someone’s got … They need a hysterectomy because their cervix is hanging out of their vagina, they don’t need to come see me.
But there are certain things that I do know how to help. So, let’s say that one of them is dyspareunia. So instead of talking about … I always have to think about how to spell that word. So instead of talking about my O-Shot®, why don’t I talk about one of the problems that I do know that I have a high success rate for? Dyspareunia.
Now I know this is like back pain, there’s lots of things that cause dyspareunia. So, we could just pick one of those, but I’m just going to leave it at that for now. We can say dyspareunia post episiotomy, let’s just say dyspareunia. Actually, why don’t we say dyspareunia post-partum. Post-partum, and just make it more fun.
So, this is what I know. Dyspareunia post-partum, we’re the bomb, we’re the O-Shot®. So now, so that’s step one. Number two, and then we’ll just follow this, and I’ll show you how to do this. Literally, five minutes, you’re done with an email. That just kills it.
So number two, you say … okay, so first it’s the what do you want to market? Next, is what problem do you want to solve with the thing you’re marketing? And I’m trying to move this down to number two because that really should be number two. So, make this number two. Ugh, it won’t go. Okay.
So, what problem? Dyspareunia post-partum. Now you’re going to go to PubMed and go to Google, and see, you’re going to find some research. And this is where it gets fun because you should be wanting to read this anyway if you’re treating it. So, let’s just Google it first. We go Dyspareunia post-partum.
I’m telling you, I’m giving you the keys to the kingdom. This works so very, very well. Okay, so definition, not interesting. Okay, this looks like a full text clinical trial that’s underway, but clinical trial’s probably not finished, so … I’d like to find something that’s done.
Okay, episiotomy and the development of post-partum dyspareunia. Done. Apparently, Google likes that. So this will save me from doing the PubMed thing. And let’s just quickly scan it, see what it’s saying. Now here’s the thing. If you have a patient, or if there is someone out there, not even your patient, is dyspareunia post-partum. They can look at this, smart women, they can look at this, figure it out … But even though they’ve figured it out, sort of, they’re not sure if they’ve really figured it out.
And they would love to have a physician think about it with them, and tell them, “Yeah, this is what it means.” And they would even better like it if it’s their physician who’s thinking about it. So, let’s just scan this really quick. Episiotomy, common surgical procedures, a study, episiotomy [inaudible 00:44:11] 39%. [inaudible 00:44:13] sex life, largely unknown. Three months post-partum. More severe dyspareunia … Okay, the aim, assess the impacts, development of post-partum.
So, materials and methods. Let’s just scan it. [inaudible 00:44:32]. Interview, questionnaire, so these are questionnaires, visual analog scales, so we’ll skip down to the results. Of the 200 hundred patients that participated, 100 had vaginal delivery with episiotomy, 100 had C-section all were primigravida. In ages 22-24 years old, okay, characteristics, average incontinent scores, dyspareunia was present. 21% of of group one and 8% in group two. So significant increase in the presence of dyspareunia. So that’s the conclusions right there. Present, not present, so there we go.
So now, situation, whatever [inaudible 00:45:34] dyspareunia. Okay now, here’s how you write the email. Let’s go back to our list, we’re going to need this link right here. So I copy that link to the research and let’s get the numbers down here. Was it 21% versus 8%. Okay. So now, let’s write our email. I like to do Ulyssis, but you can do whatever, I don’t like all the extra stuff in my way when I’m trying to write. So hello, and then you’re going to put first name. Dyspareunia, painful, painful intercourse can put a huge strain on family and relationships. Recent research looked at the percentage of women who suffered with pain after delivery, and found that the percentage jumped from 8%, if there’s a C-section to 21% or about 1 in 5 with vaginal delivery. Now, can you see now you’re talking to your patients like who they are, smart people. And you just learned something. The solutions, my cursor just jumps around, solutions to this problem can be very unsatisfactory. We’ve found that the O-Shot®, procedure can be helpful in most women. Okay. If you know someone who suffers, of course this someone could be the woman reading this, maybe she knows her mother, sister, best friend has problems. If you know someone who suffers with this problem, would you mind letting them know about possibilities of seeing better. I’ll just stop there. Possibilities with the O-Shot®. Sincerely, okay.
Now, you can take this and copy it. However you send your emails, alright, we’re almost done. I don’t know how we’re doing for time here. However you send your emails then. I like using Ontraport.
So you can see I have my contacts sort of sorted out into lots of different categories. For now, you should probably just have one list that your emailing to, but, I have a list of O-Shot® patient inquiries. So about 6,000 people. So we’re gonna send an email to all these people and try to get them to come see you.
So I’m showing you how to write an email. So now selected all those people and this is how you finish off the email. Use [inaudible 00:51:03] contact, whatever you use it will work the same way. So email for me, and then let’s say new, I like to have a promise embedded in the subject, so, 21% of women would be interested in this after childbirth. Okay? Now I take that, what we just copied that we wrote. And again I like using it in whatever your favorite editor is. Now I need to put in the first name and how this works with your software, it’s going to be very similar, but now we need to put the website. So I can say click to read the research. Then you come back up here and find that paper, so back over here, and you just copy that domain name, and then come back to where you’re writing your email, you still with me?
So, click to read the research. I’m showing you how to write something, and the reason people are not going to put this..they’re going to read your emails if you send them emails like this. What I just did was I copied, paste that into that link and I always want it to open up a new window. It’s just a little hack I do to that makes people stay with you.
So they all work the same, they’ll have a little chain link picture, you highlight whatever you want the link to be, then you click on the chain link and you place the domain into the box. And then make the target a new window and then you save it. Alright?
And the we want people to go to the O-Shot® procedure and find you guys, so I am going to the directory for the O-Shot®, O-Shot.info/ actually, I’m just going to put the O-Shot® webpage and then web coach. Now, that’s it. And then you put name, its helpful I think if you have your signature as a picture so you can add your signature in. So, we’ll find my signature, put that in. And even if you have someone else do this, at least if you understand how this can be done you can create the content and have somebody else do this. I think its good to put your phone number and then always put a P.S.
I like putting the little reverse arrows if I want somebody to click on something, because they see that and it slows them down.
Okay, so lets go back and look at what we’ve done. Now I’m going to send it here in a second here in a second and let you see the final. So we first thought of what we’re going to market. Then we decided it was going to be the O-Shot®. And we decided a problem that thing we’re marketing would fix and we picked dyspareunia post-partum. When we googled it we found some research, then, we wrote by an email, just letting people with the problem know about the research and offering your solution, see number 1. So that’s where you put the link. That’s it. Then you send it. Alright so lets go back here, and the other thing before I send it, is I like the text to be at least a font of 16, because people reading this on their Iphone and a lot of them are like me and need reading glasses, they can’t see the little letters. And it’s nice if you put a new picture so people remember what you look like, remember they’re not really thinking about you that much, they’re thinking about their own problems. They don’t really care that much about you. So putting a picture there helps them remember you. And then we send it.
Before I send it I will often make sure to make sure that they do work. So you can see now if I click to read the research it opens a new window, it takes me to that research. And then if I move to the O-Shot® I made that window just taking them there so they will find you and I then I should find the science here and I send them to the research page. Make sure that one works. Yep, were on the research page. So it’s ready to go. And that’s your formula so you go ahead and send it. Hopefully some of these people will actually come see you. So save and send. I think with that we are right at the hour and hopefully you guys got something from the questions and my little tip about how to send out emails to people who actually want to read. Those will rarely go into the spam folder and you’ll get about a 30% opening rate, consistently, if you do what I just taught you. Alright I guess that’s it. Let me see if there are any questions and we’ll shut this down. None? I don’t see any questions so thank-you guys, you guys have a good week and I’ll post a recording to this to the CMA website.
Here you’ll find listed some of the research listing results from using the proteins found in amnionic membrane (amnion). The cells are not living (all potential pathogens and the living amnion is killed using gamma radiation, but the proteins are kept intact)…
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…
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-
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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)
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.
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.
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-
Section 2 of 5 [00:10:00 – 00:20:04]
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.
Section 4 of 5 [00:30:00 – 00:40:04]
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?
Speaker 1: Okay. I’m gonna put that in the chat box. Thank you for that top. Let’s see.
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.
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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