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

 

Q&A. Writing emails, amnion, treating scars, cannulas, loss of sensation.

Relevant links…

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?

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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.

Okay.

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.

Section 5 of 5 [00:40:00 – 00:58:14]