JCPM2018June27.BeautyMathResearch(face&labia).PRPTuneUp.FDAWarning.Altar™Story.HandsOnClasses

Topics Discussed Include the Following…

[note, these weekly meetings are usually only held with our CMA members, we occasionally post the meetings for any provider who may wish to enjoy with the hopes that they may both find benefit to their patients and that they may consider joining us]

*Beauty analysis math & science of face & labia.
*The Beauty & the Beast
*New review paper of the aesthetics of the labia
*Tune Up your PRP protocol from a basic science paper
*FDA & PRP
*Strong warning about profiting from PRP kits and teaching PRP procedures [don’t]
*The Story of Altar™
*Up-coming hands-on classes with live models

Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips

Transcript

Beauty Analysis. Face & Labia…the Math of Beauty

If math applies to the face, does it apply to the labia?

Charles Runels: So first, let me say congratulations to Dr. Alinsod, who just published another paper. We definitely want to get to that. I think let’s start by teeing that [research up] with some ideas that I think are widely accepted about the face. This is a website that is put out by Dr. Marquardt, who did some studies about what [mathematically] makes the perfect face, which you kind of have to think, “Well obviously, we were all made to be beautiful, and so, is it okay to decide what’s perfect?”

We’ll get to the labia. But I think most people are accepting that there are certain ideas that we recognize to be beautiful, although of course our affection for each other changes the beast into the beauty in the fairy tale. And of course that happens … It’s a metaphor for what happens when we fall in love with each other.

We know genetically we’re usually attracted to someone whose eyes are of similar color to our mother or something else about the face [that may be genetically determined by our brains]. There are certain mathematical things that go on, as Dr. Marquardt has shown with much of his research.

For example, the upper lip is usually about half the width of the lower lip [in the face of those we consider most beautiful]. I’ve put a link to this, or I will put a link right now into the chat box. Most of you guys are aware of this, because if you’re doing our Vampire Facelift, because I talk a lot about Dr. Marquardt’s work. He was an engineer before he was a physician, and did a lot of really accurate measurements with calipers before we all had computers on our desk and then translated that over. If you look at what he actually talks about here, how if you go all the way back even to, you can see, in former times …

It’s worth browsing this website because even if you look at artwork from ancient days, on every race, every race every continent, you’ll see the artwork very carefully closely matches what we talk about is beauty. I bring that up not just because many of us are doing the faces, but because it’s a major idea that is coming about in the cosmetic world, as most of you guys know. Dr. Alinsod just published something, and I’ll let you take a look at it, and I’ll provide a link to it. Let’s see. Let me pull this up for you. There you go.

So this just came out. Dr. Alinsod and Dr. Güneş … I suppose I probably said that incorrectly … published this paper where they talk about the ideas of aesthetics for the genitalia.

It’s interesting that in the days of Fifty Shades of Grey and such, in my opinion that, we can readily … The reason I started with talking about the face is…

it’s very unlikely anyone had any problems thinking about the idea that certain measurements [of the face] might be genetically embedded to our perception of why it [an individual face] might be beautiful.

And yet, when you swap that same idea [which also applies to the] figure and the breasts, when you swap it to the labia, people start to balk.

There’s a very strong political movement, both pro and con, and some of the thought leaders like Dr. Alinsod are trying to play a scientific role and leadership role and taking lots of heat for it, and teaching the world that maybe if it’s okay to think in that way with a face, it’s okay to think about it [in regards to] the labia. And so, in this review article, he talks about surgical and non-surgical ideas relating to aesthetics.

The references are very helpful, and I will put a link to this in the chat box right … Actually, it will be on the page for the recording for this once the transcript is posted (click to read).

But the couple of ideas that I would point out, and then I’ll open the mic for discussion. The things that caught my attention were, first of all, how strongly some of the ideas are opposed

and then just in general how [in following] the idea of making things more beautiful, we have stumbled upon how it [creating beauty] also is making things more functional.

Another reference concerning the math of beauty

Dr. Goodman was on one of our previous journal clubs, where he talked about his research showing that women actually have better orgasms and better sex when you do some of the things we’re talking about now, when it comes to just [improving] the appearance [of the labia in the eyes of the woman]. Let me swap something over. I want to show you an example from my practice. Let’s see here. So this is from the Vampire Wing Lift™ website, which if you’re doing the O-Shot®, you should have also a listing here. If you don’t, let us know about it. But if you go on the before-and-after photos, there are several here that were supplied by our providers.

Here’s from Carolyn [Delucia, MD, FACOG], and you can see there are others over here. But the one I want to bring up is this one, because I know the woman. She’s actually one of our providers. If you look at this, you’d think, “Wow. This is a lot of volume loss,” and you might think the rest of her body may look not so young by looking at her labia majora.

 

Click to see the after photo<–

The truth is this woman was so fit that if she … If you saw her at the gym, you would think, “Okay, that’s a 60-ish-year-old woman, and that’s the way I want to look when I’m 60-ish,” because of course when women lose the fat in their body and stay lean, they also lose it in the cheeks [which is one of the reasons we do HA fillers and the Vampire Facelift®].

But what hasn’t been talked about is they [lean women over 35 years old] also lose it [faty] in the labia majora. And so, simply by adding volume back, with the combination of PRP and an HA filler, we’re able to easily restore this more youthful look in a very quick procedure. Now of course, Dr. Alinsod talks about surgical ideas as well in that paper I just showed you. I highly recommend this book, which also has a … And this will be the bottom when I post the transcript in the video for this webinar. I’ve already put the links here. But this book has a section on both the surgery as well as PRP and radiofrequency and laser and all the rest.

So, it’s not just for surgeons. I’ve never seen this price. It’s usually $230. I’m not sure why it’s dropped in price like that, but it’s a good time to buy it. I think I’ve talked enough.

Let me see. If anybody else wants to comment before we move to the next topic, please let me know. But I want you guys to know about this because it’s one … I would show it to your patients. Give them permission to do whatever feels natural to them. We’re not taking people and making them feel self-conscious about their body, as some might imply.

We are taking people who want to make all parts of their body well and functional, not just their bicep or their spine or their brain. Or why should we think about optimal brain function, optimal flexibility, cardiac, VO2 max, anaerobic threshold and not think about sexual function? It’s a pretty obvious, rhetorical question that some people have trouble with. So, empowering your patients by giving them links to our references, and I will post the one I just showed you at … If you go to just any of our websites, like you go to OShot.info or Vampire Facelift® or any of them, you’ll see a research tab at the top.

Even on Vampire Wing Lift®, we have actually a paper showing benefit from that procedure, Juvederm with PRP, combined in the labia majora. So there it is right there. Okay, so, I don’t see any hands up. I see Dr. Harrison on the call. I’m going to unmute you because Dr. Harrison told me about a really fascinating paper about the basic science of PRP. So, let me pull it up so you could talk about it. I’ll put a link to this one, as well. Let’s see. Why don’t I just go ahead and put that. I’ll put this one in the chat box as well.

All right. So there’s a link to get it.

PRP Tune-Up

click to see PRP basic science research<–

So here we go. I’m going to unmute you, Dr. Harrison. Are you there, Dr. Harrison?

Dr. T. Harrison [Theodore Harrison, MD MBA ABAARM]: Yes, I’m here.

Charles Runels: There you go. Talk to us about this paper.

Dr. T. Harrison: Well we thought this was a really interesting paper. One of my Canadian colleagues sent it to me about a week and a half or two weeks ago. We have a little research group here in Victoria, British Columbia, where we have our little lab. We do a few experiments from time to time on different PRPs to try to find out what makes the best and how to make PRP and stuff like that. So when this came across our computers, we thought it would be interesting to see what these guys said and see if there was any way to make it practical, because this is a lab paper from Argentina.

It’s not very practical the way it’s presented here. What these guys did essentially was they took PRP, and they use a double-spin method for making PRP, which is unfortunately not described in the paper. But it’s referenced to a previous paper that they did, so you can find out how they did it. But anyway, they took PRP, and they did a couple of things to it to see if they could make it better. The first thing they did was they took it down to four degrees. They put it in a refrigerator and they got it down to four degrees for half an hour.

Then they tested it to see, with the various growth factors, and there are some pictures there about they tested migration and embryonic cell growth and how it affected it and the like. Yeah, you can see right there. Those pictures there are the first ones from the cold. The top graph is cell growth, the middle one is migration, and the bottom one is new blood vessel formation. They found that if you took just the … Well the control there on the left-hand side, that’s just fetal bovine serum. So there’s nothing in it.

Then the middle one is PRP releasate, which is to say, they took PRP and they activated it with calcium. I think maybe they tried thrombin too. Then the third bar from the left is washed PRP releasate. That is, they took PRP, and they did a second spin so that all the platelets formed a pellet now at the bottom. Then they removed the plasma from it, and they washed it with some kind of lab solution stuff, not really necessary in my opinion. But then they reconstituted it and activated it after exposing it to cold.

Then you can see what the results were. They got more migration, they got more angiogenesis, and they got more human embryonic cell growth from it. Also in the references, they have a good reference to the paper that gives good overview of what cold does to platelets. And essentially, what happens is, when platelets get cold, they get a lot more sensitive to activation, and they’re pretty sensitive to begin with. I mean, almost anything can cause a platelet to activate. I mean, I made a list once and it had like 20 or 30 things documented that cause platelet activation.

The only thing that keeps this from turning into a clot in five minutes is the fact that there are anti-activation proteins circulating in the whole blood. So that if a platelet accidentally tripped off, it just doesn’t set off the cascade and clot your whole vascular system. But, the fact is that they got a lot more results when they took away the plasma, and they got a lot better results when they made it cold. The second thing they did was take away the plasma.

Now, I’d heard a lot before that plasma helped PRP or helped the platelets in PRP. But these guys have some pretty interesting results here that show that if you take the plasma part away, the PRP actually does better. This is the washed platelet releasate part that they have there.

Dr. T. Harrison: Have there. So that was kind of interesting too. It doesn’t look … I can’t really tell from their data whether they cause lysis or not by doing these things. We know that lysate performs better than PRP by itself, and I guess I should define a couple of things here. Everybody on the call I’m sure knows what platelet rich plasma is and platelet poor plasma is. But there’s also a couple of nuances. There’s platelet releasate and platelet lysate. Platelet releasate is what happens when you make PRP, and then you spin it down and you add calcium to it. And then you spin it down again, and take off the remains of the platelet. So all you have left is the plasma, and what got dumped into the plasma from the alpha granules and delta granules after it’s activated with calcium, or something like that. That demonstrably performs better than just PRP by itself.

Now, platelet lysate is what you get when you take PRP and you spin it down, and you take all the plasma off, and you lyse the remaining platelets. So in that case what you get is a hodgepodge of everything that was in the platelets. I mean, it lyses the platelet cell membrane, but it also lyses the alpha granules, the delta granules, the lysosomes, the mitochondria. I mean everything that was in there just gets dumped into the mix. But what happens, this results in much higher concentrations of the growth factors and cytokines. And the research so far tends to go toward lysate being even more powerful than PRP, or PRP releasate as far as growing human embryonic stem cells. I mean human embryonic cells, our concern.

So these guys did the cold, and they found that that made the releasate more powerful, and they took away the plasma, and they hypothesized … and that made things better too. Again more immigration, more angiogenesis, more human embryonic cell growth. And they hypothesized that there were inhibitors in the plasma that were keeping the PRP releasate, the regular PRP releasate, from it’s full potential, you might say. And then when you got rid of the plasma, and then activated the cells and or lyse the cells, then you didn’t have these inhibitors anymore, and that’s why the plasma-free PRP I guess releasate you’d call it worked better.

And then they did one more thing. They also tried adding cryoprecipitate to the PRP to see what that would do. And they made the cryoprecipitate by basically freezing their PRP, or spinning down the PRP, taking off the plasma, and then freezing that plasma. It’s basically fresh frozen plasma. But they froze it for 24 hours. And then they warmed it and centrifuged it again to get the precipitate, which is mainly fiber and fibrinogen, von Willebrand’s factor, and a few more proteins like that. And so they took that precipitate, and they added that to their PRP as well. And they didn’t quite document so well what happened there, but it does seem like these proteins form a matrix which allows better migration. And it also has a little more effect on proliferation, though I think it didn’t have much of an effect on angiogenesis at all.

So basically they got three different ways they could make PRP better. You know, make it cold, take away the plasma, and add cryoprecipitate. So, I dunno, for office purposes, making the cryoprecipitate’s probably not very practical. But the other two are probably pretty easily doable, so we ran a little experiment ourselves here. Basically we took some PRP and we took a 3 cc syringe of PRP and we wrapped it in an ice brick. You know, one of these bags full of something that freezes really easily that you put in the freezer and then you put in a cooler or something. We just wrapped that around the 3 cc syringe, froze it, and then we took out the or empty 3 cc syringe, and we put in a 3 cc syringe full of PRP, and we took the temperature to see how long it took us to get down to four degrees. And it took about four and a half minutes to get the temperature of the PRP down to four degrees, same temperature as they used here.

And then we ran it through the hematology analyzer to see what happened there. And we found there was probably a little lysis. But not much else happened. It didn’t look like they were activated yet at that time. So for practical purposes, it looks like you can make PRP cold in about four and a half or five minutes. So that might work in the office pretty well.

And the other thing of course is just taking the plasma off, so it doesn’t inhibit the growth factors and cytokines that are released when you make releasate, or when you make lysate for that matter. And that’s just easy to do. You just after your second concentrating spin, or maybe during your second concentrated spin, you just spin it hard enough so the platelets form a pellet down at the bottom. And then you just take off all the plasma. And then you can reconstitute it with water if you wanna get a lysate. Or with D50 if you want to get a combination lysate releasate. Or maybe with normal saline if you wanna just get a releasate out of it.

So that’s pretty easy to do too. So from a practical point of view in the office, you could do about two thirds of the things that these people did to make their PRP more effective. And you can see from the graphs, that they got anywhere from 30% to 50% improvement in their PRP results when they did these things. So it looks like it might be pretty effective stuff.

This is only one study, and I hope other people will do other studies that’ll confirm this. But it is pretty exciting that you can increase your PRP effectiveness this much with some pretty simple things that you could do in the office.

Charles Runels: That’s very fascinating, and I was not even aware of this paper, so I’m sure everyone’s cheering you for, and just the fact that you told me that you went and counted by reading the research 30 different ways to activate platelets, I’m impressed and very grateful. My impression is that if anyone studied this paper in detail, they would have to come away understanding platelet rich plasma in a deeper way whether or not they adopted the techniques or not. You know, just the reading of the introduction to me was encouraging. Just as a reminder, as they go through as their intro for the study, the safetiness of it, and they go just these three words: recruitment, proliferation, and differentiation of stem cells. We all know that, but just to be reminded, all those things are happening, especially to those on the call who are new to platelet rich plasma. That’s what you’re doing. That’s a powerful statement.

And then on this next page, as you were mentioning, they say surprisingly, I think that’s an understatement to say that in something called platelet rich plasma, the plasma’s actually decreasing the effectiveness of angiogenesis. And they talk briefly here about why that could happen and give a reference. Anyway, you’ve done such a wonderful job of talking about it, I’m not going to muddy the waters anymore. But could you expand more on, having read this now, has it changed your practice as far as your daily … and you know Victoria Canada, like when you take the boat from Seattle up to that beautiful, amazing place right there. Is that where you are?

Dr. T. Harrison: Yep, that’s where we are.

Charles Runels: Wow, I was there once. I don’t see how you get any work done living in such an amazing place. It’s so beautiful there. I would just be outside, gawking all the time. So how has this [research under discussion] changed what you do? Or has it?

Dr. T. Harrison: Well, we haven’t really tried this on patients yet, but we’re definitely going to, because it’s really easy to just put your PRP in a freezer brick for four or five minutes. And it only adds a little bit of time to the preparation, and it’s pretty easy to take off the plasma after a second spin, and then reconstitute it with something. Now the question that we have is what do we reconstitute it with? Because we did a study earlier this year, which we presented at the AALM Conference, where we took PRP and we diluted it 50/50 with different concentrations of dextrose. Because we’re really interested in prolotherapy and using this in joint. And dextrose has been the main deal for prolotherapy for many, many years, ’til people started using PRP. We thought the two might be synergistic, so we decided what would happen if we added them together?

So we did different dilutions, from basically to sterile, distilled water, all the way up to D50. And we mixed them half and half with PRP, regular PRP, to see what would happen. And of course when we mixed it with water, we got about 80% lysis of the platelets. So it was almost a perfect lysate. Not quite, I don’t know why those last 20% of platelets didn’t lyse, but they didn’t. And at D5, D12.5, and D25, we got about maybe 15%-20% lysis. There seems to be something in dextrose that platelets are sensitive to. At least some platelets are sensitive to.

But when we got to D50, and we added one cc of D50 to our one cc of PRP, we still got 20% lysis, just like we had with all the other dextrose concentrations. But the other 80% of the platelets activated. The lower concentrations of dextrose did not activate the platelets, but at D50, all the platelets activate. The rest of the platelets activate. So you get a combination of lysate and releasate at that concentration. So that’s what we’ve been using for prolotherapy.

Charles Runels: Interesting.

Dr. T. Harrison: Now, for other uses, I’m not sure whether that would work or not. It certainly gets you activation, and dextrose is good for platelets, because platelets use dextrose. They eat it. They feed off it. And when you give PRP normally, the platelets don’t just dump all their alpha granules and die. They continue to live for about five to seven days, and they release further alpha granules in waves. So it’s not all the alpha granules that get dumped. And when you activate with calcium or with thrombin, it’s only the first wave. Because the alpha granules contain both pro-angiogenesis factors, and anti-angiogenesis factors. They are pro-inflammatory and anti-inflammatory. And they have both pro coagulation and anti-coagulation factors in them.

So it wouldn’t make any sense to dump all the pro’s and anti’s at the same time. And so they don’t. You get a first wave that’s probably mostly the pro-inflammatory, pro-coagulation alpha granules, and then you get a second wave, maybe within the next day or two, that has the anti-inflammatory, and maybe the pro-angiogenesis ones, and then so forth. They go through five to seven days of releasing new waves of alpha granules as they do their job. And it ends up the last wave is gonna be the anti-angiogenesis as they knock off all the little blood vessels that they made that they didn’t need anymore once the healing is all finished.

But when you make regular PRP and inject it, that’s what you get. The platelets stick around, they release their alpha granules in waves, it’s sorta like the normal healing process. When you make a lysate, all those guys just get dumped together. The pro’s and the anti’s and everything else, from the lysosomes and mitochondrian. It just all gets dumped together. But it seems that the much higher concentrations of growth factors that you get from that outweighs the presence of the anti-coagulants and the anti-angiogenesis. You know, the other factors that would normally work against the new migration growth, cell growth, and all that sorta stuff.

So, so far at least, it looks like lysate’s the most powerful PRP preparation. And so we’re thinking maybe we outta cool it, or maybe we oughta wash it, and then cool it, and then reconstitute with water, and see how much of a lysate we can get from doing that to get the maximum potential out of the PRP.

Charles Runels: Wow, what a wealth of knowledge. You should be teaching. It sounds like you probably are, but if you ever want to teach our procedures, I would certainly show up as a student to see how you’re thinking about it. One other question. If you look at this just as a reminder, and you’re doing this, when they talk about how PRP is used in regenerative medicine, it mentions of course muscle damage which you guys are doing as doing prolotherapy, I’m sure you’re treating that already. So if you were, as we’ve developed our O-Shot® techniques around the pelvic floor and the vagina and the urethral space, if you were treating a woman who had dyspareunia and had pelvic floor tenderness, or if you were just treating incontinence and using PRP in combination with an Emsella machine, where in theory, you’re causing strengthening of the pelvic floor, in those two cases, if you would … Because the thought is, of course, that perhaps you could inject the pelvic floor if you’re trying to strengthen it and then do your m-cellular treatment with the electromagnetic stimulation of the muscle, and maybe get a better result than if you did just one of those alone.

Note…we offer an icon on our directory to identify O-Shot® providers who also offer Emsella, radio-frequency, or laser in conjunction with the O-Shot® procedure. If you are offering these combination therapies, please let our office know so we can add the icon to your name on the directory (support@cellularmedicineassociation.org).

Where would you inject, and how would you treat your PRP before doing something in the pelvis or vagina, where the idea was treating either dyspareunia or pelvic floor laxity, to help incontinence?

Dr. T. Harrison: Well, if it was for stress incontinence, I’d be fairly cautious because, you guys have run into cases where basically, you caused urinary obstruction from people injecting too much PRP around the urethral area. And since this is more powerful PRP, I’d want to sort of proceed cautiously there, using this sort of enhanced PRP stuff.

Now, for pelvic muscle floor, I don’t think that would be so much of a problem. And if you inject along the top of the vagina, out to the sides, along the course of the urethra using these more powerful solutions, you might actually be able to strengthen the whole pelvic floor that way.

Charles Runels: Or, if you were, say, treating pelvic floor tenderness, a trigger point injection for dyspareunia with pelvic floor trigger point reproduction of the pain, you would do … When you say that way, would you do your lysate with water and cold technique? Would you expect that to work better?

Dr. T. Harrison: I think I would expect it to work better than just plain PRP. Yeah.

Charles Runels: Yes.

Thank you. That’s helpful. To think about the overflow incontinence just to … Thank you for bringing that up, just for the rest of the people on the call, if you haven’t heard of that, we’ve had so far, I know of three cases. In every case though, the reassurance is that the volumes injected were 7 CCs or more, and so it’s yet to happen with our recommended 4 CCs. If you look, inject 4 CCs, it may not sound like much, but if you injected say … Imagine injecting, if when we do the face, we just inject one, it’s a pretty large volume. So, our thinking is, it’s probably more from a volumetric fact, but I appreciate your caution, would maybe if you had more platelet-rich fiber matrix formed, because of changing the consistency, perhaps that might cause it as well.

The other reassurance is that, in all three cases that I know of, that it within a week of an overflow obstruction basically from having created artificial hematomas, is really what you’re doing, it resolved, and the people did very well with the eventual resolution of their stress incontinence.

It’s pretty scary, though, when your person comes for stress incontinence and then they have to wear a diaper for weeks, because they’re dribbling all the time.

So, people don’t usually like that.

Dr. T. Harrison: Yeah, and the other thing you want to remember with using at least the plasma-free technique here is, you’re not going to get a fibrin clot, because you’ve taken all the fibrin, fibrinogen, and stuff away, so if you’re using it for maybe things where you want the PRP to all stay in one place like the O-Shot and scalp type things, where you don’t want it just wandering off, and diffusing really rapidly, you might not want to do this.

Charles Runels: Interesting. Yeah. Very good.

What a wealth of knowledge you are, I would want to spend the next two hours talking with you.

One of our physicians, Pamela Kulback, who’s one of the interventional radiologists in our group, typed in the question, about using, perhaps, the centrifuge. That is itself cool.

Do you know of such a device? Or do you have something in your-

Dr. T. Harrison: Oh yeah. We don’t have one, but refrigerated centrifuges, well they’re a bit expensive of course, but they’re easy to come by. All the labs have them, and you could do it that way.

The thing is, if you put the PRP in a refrigerated centrifuge, you would refrigerate it before you removed the plasma, because the plasma is still in there when you do that, and you might pre-activate some of the platelets when you did that.

So we prefer the technique of getting rid of the plasma first and then making it cold, so that we don’t have the plasma interfering with stuff while it’s in the centrifuge.

Charles Runels: Beautiful!

Well, stay on the call because we may want to pick your brain again. I think that covered the research we were going to talk about today.

FDA Approval of PRP

There was one question on the membership site that brought up the FDA question again, so I just want to remind everyone where I put that, of course thankfully, the FDA doesn’t drift all the way up to Victoria, but some of us have to think about that, so I’m going to open this where you guys can see where it lives.

FDA & PRP click to read<–

And again, this will be posted to all the membership sites. But I’ve kept this page as up-to-date as I can (if someone finds another paper, let me know) but I’ve put here actual articles by the FDA where they have talked about, in very specific terms, they do not regulate platelet-rich plasma.

In the United States, they do regulate the devices and I think you’re safest in the US by using a device that is approved by the FDA to prepare plasma to go back into the body.

Now, in other countries, maybe that’s not such a big deal, assuming you have the depth of knowledge you just heard displayed.

There actually are people in the US who have a different level of laboratory that they’ve had approved by the FDA, essentially, the FDA has come in and said, “Yeah, you’re able to do this.”

But unless you have that in the States, I’d recommend you use one of the kits.

So the short of all this, and again, I have multiple references here, where the FDA is talked about … this isn’t second-hand knowledge, they’ve done articles for the New England Journal and their own website, and I have a video that explains at least my idea about it, and a transcript.

So anything that has to do with the FDA and PRP, we are in good standings.

The one thing that I would be careful about that I see going on and it’s nothing unethical about the intentions, but as far as the FDA goes, you could get slapped around some, is, if you are a physician and you are doing these procedures, and you are also selling therapy kits to physicians, as in, you are teaching usually, and you are either directly or indirectly profiting from selling PRP kits, in my opinion and in the opinion of the FDA (so I’m giving you a very gentle warning), the FDA has shut down sales people who teach what to do with the plasma because you’re teaching what the FDA has not said the device is able to do, they’re [FDA] only saying the device can make the plasma. The FDA doesn’t approve specific use for it.

WARNING! So if you’re profiting from the device, and you’re teaching something that no one’s proven the device is capable of doing, whether you’re the salesman who’s selling and teaching, or you’re the teacher who’s teaching and selling, you should be looking over your shoulder, because the FDA could come slap you around in a pretty dramatic way.

But other than that, as far as using it, if someone else is selling it to you, they’re profiting from the kit and now as the physician, you’re deciding what to do with the blood or the blood products, the FDA is very plain. They’re not at all bashful about telling you, they have no interest in telling a doctor what to do with blood, as long as you’re not manipulating the tissue to the point that it becomes a drug, and part of the point of a lot of these articles is that, when it comes to stem cells in the US, once you do a certain amount of manipulation, it gets reclassified, and now they are very interested in what you’re doing with it and again, unless you’re in a study, you should look over your shoulder in the US.

So that’s the quick version of that.

We’re coming up on the end of the hour.

If anyone else has some questions they want to throw in, I’m getting close to our topic list here.

This, we just posted, I’m not going to waste your time getting there again, but with [inaudible 00:40:24], I posted a video, actually had a interview with the guy who patented the ingredient … a cancer researcher at Harvard, then a cancer cell biologist at Berkeley, it was shocking to me when he told the whole story about how this product came about. I knew there was a lot of thought in it, but I didn’t know that it had directly six years of research on that level and a $2 million NIH study behind it, initially for the study of wound healing, which of course is related to cancer, as it involves cell growth.

So you can find that … I’ll put a link to the video, but it’s a really beautiful thing to hear him talk about his research and the team that worked on the main patented ingredient that’s in here.

I feel blessed that we [member of the CMA provider groups like the Vampire Facelift® and Vampire Facial® and O-Shot®] have the exclusive on this.

Here’s where to buy Altar™ at wholesale prices<– (only available at wholesale price to our CMA members)

So it’s an idea to use post-treatment for the face, for the labia, (even for the penis) and I just wanted to remind you that it’s there and we also have classes coming up,

Next classes with Dr. Runels teaching procedures and marketing<–

Next classes world wide with faculty of multiple specialties<—

so if you want to check that out, and I think after that, that’s all I have to say today.

I can’t tell you how grateful we are, Dr. Harrison, for that amazing discussion about platelet-rich plasma. That’s just maybe the most detailed, informed explanation maybe that I’ve heard of the research on these calls so thank you for being on the call.

Okay so I don’t see any other questions, so I’m going to shut this down. You guys have a wonderful week.

Good-bye

Next Workshops with Live Models<---
Relevant Links

Beauty Analysis Facial Topographical Map<–

A review of aesthetic gynecology<–
Next Workshops<–
Optimized PRP<–

FDA & PRP<–

 

 

 

 

 

Cellular Medicine Association
1-888-920-5311

 

JCPM2018May30.DocumentingPenis.HowLongBetweenLaser&OShot.BellsPalsyTx.ParkYourPodcast

This sample of our weekly journal club is posted as an example of part of the benefits our joining our provider groups. We do these meetings weekly...every week and feature physicians and their amazing research from around the world.

Topics Discussed Include the Following…

*Documenting the Penis
*Documenting the Penis by text (in a private way)
*How long to wait after the O-Shot® before getting a Vaginal Laser treatment?
*Treating the Bell’s Palsy with the Vampire Facelift®
*Where to park your podcast
*Emsella

Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips

Transcript

Documenting the Penis

Charles Runels: Welcome everybody. Looks like we have a great turnout today. Let’s start with this question just it’s about where to find the questionnaire for men. It’s a good reminder that we should be doing something to document an objective measure of what’s happening. Moving to the O-Shot® and the Priapus Shot®, so I’ll show you where to find it for both. When you log into the Priapus Shot® membership site, and you click on the how to do procedure button, and then you scroll down. There’s an erectile scale, so it’s objective measurement of erectile function. It’s commonly used by the urologist and there it is right there. Erectile dysfunction intensity scale.

Then when you open that, it gives you a scale of from one to five, for five questions. So the lowest you can get is one on every one– times five, the most you could get is 25, so that’s where you would download that. Now, if you don’t want to, well let me take this back.

Online, Text, Documenting the Penis

If you want to continue to survey them, old school way would be to do this the day you visit with them, and then on follow up visits, but if you wanted to have it done automatically, then you’d go back over here and we have, so you go back to the dashboard and then you click on patient survey.

We will administer that for you. I recommend you do both. Do something on paper the day you visit them, and do the procedure and then follow up, but then also all you have to do is put in their name and cell phone number, and then they’re surveyed in a HIPAA compliant way with some open ended questions, also you can see we have a drop down menu so we look to see which kit you used, and other things like are they on testosterone. If someone put something really strange in here, then we have a way I can use birthdays, and the day they saw you, and you could reconstruct it and contact them, but the good thing is I can give you your data. What your patients are doing, and this will help us design future studies.

Even though it’s not double-blind placebo, there’s a fair number of data points being collected, so we can publish this in a prospective survey kind of thing, and that same erectile dysfunction scale was part of this, so questions one through five questions where they’re graded one through five. That’s where you find it, on the how to do page, and then scroll to the bottom and you can download it. Then on the same thing for the female side, there’s female sexual distress and female sexual function index, which takes a few minutes. Female sexual distress is the quickest. Female sexual function index probably takes, if they’re thoughtful about it, five minutes or so, but we can administer those also by survey. Then give you that data. So that was a good question.

How long to wait after the O-Shot® before getting a Vaginal Laser treatment?

Let’s see. This was a good, oh, well I’ll come back to that. Let’s go ahead and do this question. How long does a patient need to wait after the O shot for getting a Mona Lisa vaginal laser treatment for vaginal atrophy? By the way, you guys, you can type into the question box if you want to contribute, you can just raise your hand and I’ll unmute your mic, or you can type into the question box if you have a question or a comment, and I’ll either read it or unmute you so you can talk. This is a great question. As part of the answer to this, someone asked me for a detailed video recording that they could show their patients after they had a procedure done.

The O-Shot® procedure, so I’ll show you where I put it and I’ll recommend that you guys do your version of it. I’ll show you where it lives. Right here. If you go to the O-Shot webpage, the main site, and then recent posts, I put a podcast blog right there. So you can just click on it there, and actually the transcription is done, I’ll have that posted by tomorrow morning, but I recommend you take my transcript, and read it, and do it your own video or your own podcast, and put it on your website, and modify it based on your observations and philosophies. You’ll see I go into what to expect whether you’re doing it for like necrosis, and I go into some of the ideas about using other methods like radio frequency, the Emsella with the electromagnetic contraction of the pelvic floor.


If you are interested in Emsella, send message to the company to get a discount for being a member of the O-Shot® provider group…

if you purchase, then let us know and we will put an icon by your name on the O-Shot® directory so that women know that you offer a combination therapy of the O-Shot® procedure combined with the Emsella treatment…
here’s where to let us know…
Support@CellularMedicineAssociation.org


So back to this question, if you do the O-Shot® the day of the procedure, you could do the O-Shot® immediately after any sort of inner treatment, so you do vaginal laser, or radio frequency, and the same visit, same day, immediately afterwards you could use PRP. Same thing if you were an Olympic athlete, you’d use PRP to help recover the muscle function immediately afterwards. If you go to PubMed and just read about PRP, one time it was outlawed by the Olympic committee because it does seem to help recovery with muscle function, but then they decided to allow it.

You could make the argument that it may even help the day of using an Emsella or the electromagnetic treatment, but if you do the PRP first, then the energy’s going to denature the amino acid proteins, just like if you took insulin and shook it, or you cooked it, you denature the amino acid chain and uncode that chain so it no longer, it just becomes another protein. It no longer is a chemical messenger like the amino acid peptide or hormones like growth hormone and insulin are, which is of course why you cannot take them by mouth because the digestive system, as you guys know, breaks amino acids apart so now it just becomes like you ate a hamburger, so you can’t take insulin as a pill or growth hormone as a pill because it denatures or scrambles the message.

In the same way, if you did an O-Shot®, so the question is how long does a patient need to wait after the O-Shot® before you do the Mona Lisa, but what you can assume is whenever you do the Mona Lisa, you’re going to undo first of all the amino acid messenger chain, that are the small peptides, that are released from the platelets. Then second of all, of course the laser is going to cause damage, which is the intention of fractal sort of puncture wound as if it were doing a laser version of micro-needling. And then you have recovery or healing of that. So if you’re doing heat and you have pluripotent stem cells that have migrated there because of your plasma it appears to me that you would probably undo that as well, that growth.

I would say you would do the Mona Lisa whenever you thought the effects of the O-Shot had taken place. If you flip the order, you go Mona Lisa and O-Shot immediately afterwards on the first day, but if you do Mona Lisa first I would want to wait at least six weeks, preferably eight weeks so that you have most of the benefit of the O-Shot before you did the laser. If you look at the wound care studies that Sclafani did with PRP most of the effects were there at eight weeks with full effect at 12 weeks post treatment with PRP. I would want to give it eight weeks or else I’m attenuating the results of the O-Shot.

Using the Vampire Facelift® help Bell’s Palsy

Okay so, we covered this one with the short vagina last meeting, let’s see if anybody has, nobody has a question yet. There was a really interesting question someone had about, yeah. So Catherine Stone (check her out here) is one of our [amazing] providers in New Zealand and she also keeps an office in London, one of our teachers, she teaches a beautiful class there in New Zealand.

Dr. Catherine Stone

She teaches along with Dr. Kirshni Appanna.

Dr. Kirshni Appanna

She says, if you, well she talks about Botox [as a treatment for Bell’s Palsy], but she comes up to Bell’s Palsy, “I treat a lot of residual Bell Palsy and facial asymmetry patients this way using Botox. Once their Palsy is established how about PRP for Bell’s Palsy? Would you only use it the first six months or you think is long term?”

Where to inject, so this is a great question. One of us needs to publish this because so far three people have told me that they saw benefit years after the Bell’s Palsy.

I’ll pull this up just so you can see. The only reference I saw to it in the literature was someone who put this out where they used mononuclear cells and platelet plasma which there’s two variables–after 26 YEARS of being plagued with this condition.

Read about treating Bell’s Palsy of 26 years duration with PRP<–

But, we’ve had three different people tell me, and I’ve actually seen this as well, a Bell’s Palsy improved years afterwards. One of the people works in my office as a matter of fact had, not a Bell’s Palsy but facial surgery that left her with numbness that’d been done over ten years before she came to work for me.

I did the Vampire Facelift® for a cosmetic result and then anecdotally she noticed that the sensation had returned to her face. So, I don’t know when the time limit is for this to happen, but it appears to be that it can happen after, not just the acute phase, but months or years after the Bell’s Palsy has occurred. If you actually just look at the research, what’s been published, there’s a fair number of studies showing plate rich plasma helping regenerate nerve tissue. I think it’s because we know it’s affect on attenuating all the immune response, it’d be nice to get to these people immediately when the Bell’s Palsy occurs and see what would happen and someone needs to do that study.

There’s so much research that needs to be done based on our observations but there’s no downside and a huge upside so I would say try it and of course it’s in the distribution of the facial nerve, I would just, but there’s no downside of just putting it everywhere. I would just put subdermally everywhere. We actually used to do this eight years ago when I first started doing the Vampire and using PRP cosmetically. I would use more of it, I’d basically tried to fill every part of the face subdermally but most people found that, or some people found it a little much so I became more selective and strategic about where I place it.

But I think in the case where you’re trying to regenerate nerve, I would just consider it, putting it everywhere. Or, if you want to be more specific you put it in the distribution of the facial nerve. Okay, let’s see, we didn’t have as many questions this time, i think that pretty much covered the questions that showed up on the website. See if anybody else has any questions. We may shut this down early. The, let’s see I don’t see any other questions.

I’d like to cover when we do these journal clubs, I like to cover research that we’ve done and hopefully somebody will build on that and something about marketing. As far as marketing goes this time, I think that there was one question that came up about building out a link to sell the Altar or whatever you might want to sell, creating a link that goes on your website. I actually covered that a few workshops or journal clubs ago, it might help if I just show you how easy it is to find things that are actually on one of our pages. If you go, I’ll go in and I’ll show you. There’s a search box and if you just type that, whatever it is you’re looking for, so let’s say that we’re on this page, and by the way our Altar shipped this week so hopefully you guys are seeing that.

Where to park your podcast<–

Get to the page. Yeah. There, so whenever you’re here, you just put in the search box whatever it is you’re looking for so it’ll pull it up on any of the posts. We have many pages on these websites. Let’s see if there’s any other questions. Not many questions this week so we may just shut this down. Okay so I think that’s it. My big marketing tip, well big but I don’t know about that, but the marketing tip I have for you this time is record an aftercare, either podcast or video. For podcast I use Libsyn.com L-i-b-s-y-n.com. You can record a podcast or a video for the actor here. What to expect before your procedures, you can put that on your websites because a lot of people look at that before they have a procedure done and you’ll find that people come to you and have the procedure done because they saw your aftercare instructions. So tonight was a quick one, I don’t see any other questions so we’ll just shut this down. You guys have a wonderful week.

For workshop that includes marketing including podcasting (if you’ve attended this before, then it’s free to return)<–

 

Next Workshops with Live Models<---

Relevant Links

Apply to join each of our provider groups<—

Treatment of Bell’s Palsy with PRP (why the Vampire Facelift® could help this condition after 26 YEARS)<–
Nerve regeneration with PRP<–
What to expect after the O-Shot® [Orgasm Shot®] procedure<–

Doing your own podcast<–

Altar™
Vampire Facial® Research

Cellular Medicine Association
1-888-920-5311