Topics Discussed Include the Following…
*PRP for Hair—inject or Microneedle?
*Shock Wave for Women
Video/Recording of CMA Journal Club, Pearl Exchange, & Marketing Tips
Transcript, Relevant Research, Relevant Links
Transcript
Charles Runels:
Thank you for coming to the journal club tonight with Perla Marketing, hopefully we’ll have all those things for you tonight.
Our very special guest tonight is Dr. Carolyn Delucia who’s a board certified gynecologist to practices in New Jersey and New York City, and has lectured around the world and participated in research. And she agreed to come on tonight and share with us a preview of some research she’s been doing. And I will discover it with you guys, but I know it’s going to be wonderful. She’ll be teaching some of this in Chicago later in the month, but she’s giving us a preview.
PRP for Hair—inject or Micro-needle?
Before we do that I promised you guys of a quick… I get lots of questions about hair and some new research is out that answered a question that’s been around… I’ve been asked this for the past decade. Is it better to microneedle PRP or is it better to inject point by point?
And finally there’s some research out, very good research, to help answer that question and we will go over that shortly. We’ll spend only about 10 minutes on the research, and then we’ll introduce Dr. Delucia and find out what she’s going on. And then there’s a couple of very good questions, other questions, that were sent to me. Before we do that, though, I want to give you guys something, a confession. It’s my confession about hair, but also I think it makes a point. First of all as a kid, I was one of those weird little kids that stayed in the basement and did inventions and was a big fan of Benjamin Franklin, read his autobiography, the whole thing in grade school. And so I liked his hair and I wanted to have hair. Then I got turned onto Leonard DaVinci. He’s got the hair.
And then as a young 20 year old, I started studying meditation with the only living disciple of Paramhansa Yogananda. Are you seeing a theme here? Then of course, I was brought up Southern Baptist and taught to think you kind of get to be a sort… Anyway, I won’t go there. But that’s sort of… And then of course, as I got older, I started training a lot and became a big fan of Tarzan. And so I went for this Tarzan look, when it went all cash as a doctor but then when I started lecturing about vaginas, I thought, “How can I look conservative?” And so I started doing that. That’s my hair confession. And the point of all that is that hair makes a difference. And if it makes a difference to an old guy like me, it certainly makes a difference to young women and young men who are still building families and making babies. It’s huge.
Now here’s the article, microneedling versus point injections. And I’m going to sit here and read the whole thing to you, but I thought it was interesting. It starts off with the statement that hair thinning and hair loss affects people’s self-confidence and self image more than is thought. I sit and pondered that and thought, “Well thought by whom?” And I don’t know, we all think it matters, but I’m still trying to figure out what that statement means.
But these guys did a great article and obviously androgenic alopecia, because we’re replacing testosterone in women now, it’s important for men and women. So it’s worth thinking about, and it’s a big money maker, but it’s a money maker for a good reason. People are happy to pay you when you’re doing something that changes their life. And you can see I’ve thought about hair quite a bit because it’s a costume and it’s a costume that either you’re a thinker or you’re a guru or you’re a sexy woman or you’re a librarian or whatever. And hair says a lot. Now what these people did they had… And this, by the way, this is the first study I know that does this at all.
There may be others that do it that I’m not aware of, but this is the only one I know of where they actually compare the two. I get questions like, “Should you inject subdermal or intradermal? Should you microneedle and do injections?” And by the way, I’m going to show you some videos about all this in a second and where you can find them on the membership site. But they finally answered the question. And what they did was they did a double centrifuge and both… They had 60 something people in both groups got either… Both of them got about four cc’s of PRP. One group was microneedling at 1.5 millimeters, so intradermally.
The other group got injections where each point was about 0.1 milliliter and they were distributed about one injection per square centimeter. Then they did… One of the strong points of this is they actually did a scientific measurement. They did scales about how happy people were. They actually did this new way of measuring hair growth that I’ve never done before. Some of you guys might have done it, but it’s the new standard of measuring hair growth.
And then what they did was they showed that the intradermal injections were in both groups you got hair.
And by the way, it’s all over the map. And they make a point in this study, everybody’s doing it differently, but multiple studies you can see and their references that… And I’ll give you the link to this right now, before I forget the DOI number so you can look at it. It’s not even published yet. Thank you to Jeff inaudible 00:06:39 for putting this out to me. So there’s a DOI number. I just bought the article so I could read it all, but you can see it’s accepted, but it’s in the finishing the edits. But see, there’s some of the references and we’ve gone over more than this in our journal club. So there are many more, but these are the ones they like the best. But this is what I like more than the fact that… So both groups got growth and the microneedling got more growth, but this is really the most important part of this paper, I think.
Let me find this chart. Hold on a moment. Actually, before I do that, I want to show you a picture. I’ll come back to that chart. Don’t go away, Carolyn. We love you. And I don’t want you to go away. Hold on a second. I’m almost through with this hair thing. Let’s see.
Yes. Think about what antigen, catagen, telogen, early antigen. I just want you to look at this and kind of remember if you haven’t thought about this in a while. Basically you’ve got a hair that’s growing and you got a hair that’s ready to fall out, and it’s in a stage where it’s dormant. And what they found in this study was both groups got growth and the microneedling had more growth. But more importantly than that, I think… Let me find that chart again. The microneedling had more hairs in the telogen stage. Where is that chart? There. So you actually had with the microneedling, you had an increased percentage of antigen hair and a drop in telogen percentages. And the reverse was in the injection, point by point injection, which is what I’ve been doing. What I’ve found is if it’s a woman especially, I’m interested in the pearls someone might have, or how to do the microneedling, because the hair gets in the way.
Or if you’ve got someone like me with hair that’s cut short, of course it’s not a big deal. So that’s all I wanted to say about hair except to show you guys where our videos live. And then let me pull Dr. Delucia on the call. Let me show you, because some people have trouble navigating to it. So I think it’s better if I just show you where it lives. All right. So if you’re in our website for the Vampire FaceliftⓇ and it works like the facial works similarly and you go to the dashboard and then that’s where you go anytime you get lost. And then you go to the how to do page and click on the hair treatment part. All right, and then… Let’s see if we find it. Actually, I may… Let me get… I’m lost already. I lost myself little. Yes. Okay. So you click on the hair thing and when you get there, you’re going to see multiple videos.
And it’s coming.
There. Hair expert, Dr. Stephan, amazing hair expert. Another video Dr. Pinel 00:10:18 came on, so a whole hour talking about here, gave his secret recipes, and there’s another one. So three, four videos about hair, but all this was done and you’ll see a nice blog done here. All this was done before this latest study. So now you’re up to date with hair. You know how to find it. You go to the dashboard, you click on the hair link and you’ll find it.
Shock Wave for Women
Dr. Carolyn Delucia: (if you wish to see Dr. Delucia for one-to-one training, you can reach her at VivagSolv@gmail.com
Dr. Carolyn DeLucia
Hi.
Charles Runels:
There you are. Wonderful. Thanks for being on the call. It’s been a long time since we have caught up.
Dr. Carolyn Delucia:
Absolutely.
Charles Runels:
I have not discussed Dr. Delucia’s research because I wanted to find out with you guys. So tell me what you’ve been up to. Actually before we do that, give us the one minute, two minute summary of how you went from how your practice and your focus has evolved during your years as a gynecologist.
Dr. Carolyn Delucia:
Sure. Thank you. It’s nice to be here again. Always an honor. I started out as your routine OBGYN. And when my daughter was about 10, she was going to be in a piano recital and I could make it, do the delivery, make it to the piano recital. And of course I missed the piano recital and she had told me if I wasn’t in the audience, she was not getting on stage and she did not get on stage. So I-
Charles Runels:
Is she the one who’s now a physician?
Dr. Carolyn Delucia:
Yes, she’s a pediatric intensive care physician. She’s getting married in five weeks.
Charles Runels:
Wonderful. Hopefully she forgave you by now. So you missed her crosstalk 00:12:40 recital.
Dr. Carolyn Delucia:
And I decided no more OB. So once I stopped doing obstetrics, I could be home a little bit better and control my schedule, but my income dropped. So I started doing what every other OBGYN was doing and that was getting into aesthetics. So I started doing laser hair reduction and that led to Botox, which just came out then, by the way. I’ve been doing Botox since it became Botox cosmetic, which was in about 2002, 2004. And as time evolved, the very first laser for vaginal treatments came to the United States, which was with Alma and it’s called FemiLift. And when that arrived in the Northeast, because I was an OBGYN who understood lasers, the company ended up walking into my office and in walks this typical laser rep, handsome with a nice cocky strut. And he goes, “I have a laser that rejuvenates the vagina,” and I told him, “Get out of my office and don’t let the door hit you in the butt.” I kicked him right out. I literally pushed him out the door.
Charles Runels:
That Italian New York came out.
Dr. Carolyn Delucia:
Oh yeah. Oh yeah. Like, “Get out.” And then he comes back and he’s like, “Oh no. Please, please listen to me. It might help urinary incontinence and vaginal dryness.” And I said, “It does what?” And so I was then all in and I was very fortunate enough to have the first FemiLift on the Northeast and be their luminary for that product, which I think still is really wonderful CO2 ablative laser, just fabulous for what it does for the vagina. And then at that time I said, “What and who else is doing anything for sexual health?” And what popped up was Dr. Charles Runels in Fairhope, Alabama.
Charles Runels:
You’re in trouble now.
Dr. Carolyn Delucia:
So I got on two planes, a train, and an automobile and I end up in Fairhope, Alabama sitting in the back of the room with 15 other doctors.
Charles Runels:
In a little room.
Dr. Carolyn Delucia:
Yep. And in walks tall, handsome Dr. Reynolds. And he goes… And that would be you by the way. And he, “I know all of you want to be here because none of you could get here without at least two planes.” And I was like, “Oh my God.”
Charles Runels:
It’s true. Only the motivated come this far.
Dr. Carolyn Delucia:
That’s right. That’s right. So there I was and it’s all history from there on.
Charles Runels:
Well, you’ve certainly taken things to different level. Just so you guys know, Carolyn’s been thinking deeply, as you heard about this now for more than a decade, and I’ve seen her take over the room lecturing from, well, multiple countries, not just the US, Venice and Monaco, and I don’t even remember where all but-
Dr. Carolyn Delucia:
Dubai, I live in Dubai.
Charles Runels:
Tell what you’re up to now.
Dr. Carolyn Delucia:
Okay. So now, coincidentally, it has been many years and we know all the different types of energies that are being used in this space. And of course the whole specialty has involved cosmetic gynecology, aesthetic gynecology, functional gynecology, whatever you would like to call it. And the most exciting thing is that the shockwave therapy has been used in men. And the typical type of shockwave that’s been used on men for the past, I don’t know, five years or so is radial shockwave therapy. And that is a snappy kind of gun, as you know, from Zimmer and from stores are the most common popular brands that are out in the market. And I had one in my office sitting there for the past 15, 20 years being used. I used it for cellulite reduction and I couldn’t imagine it being used on a woman.
It’s almost like a little rubber band snapping. It’s not overwhelmingly comfortable. And yet men were having success with it. And I just couldn’t grasp it for women. And then Alma came up to me, about January 2021, and they said, “We have a new shockwave device that we’re releasing for men. We need it tested on women. It has never anywhere in the world been tested on women for sexual function, for sexual response.” There was one study out of Israel being done on low intensity, extracorporeal shockwave therapy, and the key is the low intensity. And the shockwave was being used in Israel in this study to treat vestibulodynia.
And what they were doing is they placed it in three locations on externally, not moving it, unlike radial shockwave, where you have to move the device, because you certainly couldn’t keep it pounding in one location. It would hurt too much. This device, you just hold in one location and it pulses 500 times and opposite side of the vulva, and then right on the perineum and it was reversing vestibulodynia. And Alma asked me, “Would you test this on women for sexual function?” And I said, “Of course I will.” And after feeling it, it feels like absolutely nothing. I said, “What could this possibly do? How could it even be doing anything?”
Charles Runels:
Interesting.
Dr. Carolyn Delucia:
And you just hold it in place. I decided the right labia, the left labia, and at the top of the clitoral hood is where I place it. And the results have been nothing less than astonishing.
Charles Runels:
Wonderful.
Dr. Carolyn Delucia:
Astonishing. And what it’s doing, what low intensity shockwave is doing, is it’s penetrating 13 centimeters causing-
Charles Runels:
Centimeters?
Dr. Carolyn Delucia:
Yes. 13 centimeters into the body, stimulating angiogenesis. And the results in men that they’re seeing are wonderful. But what I have been seeing in my practice… I’ve started in June and it’s twice a week for three weeks, we do a questionnaire at the beginning and it’s a modified FSFI and my little orgasmic scale. And then we repeat that at the fifth or the sixth treatment and then at three months. And now I have several patients just finishing their three months out and the results are maintaining themselves so far, because I don’t even know how long it’s going to last. But in men, the results have lasted a year. So I’m hoping that in women it’s the same, but if not, and they have to come back for earlier maintenance, that’s fine too. It’s completely a painless, pleasant, procedure for the patient and for the provider.
Charles Runels:
So maybe you’re not aware of this, but I know Richard Gaines, who developed the GAINSwave, has evolved to where he’s using a different type of shockwave device than what was originally rolled out when he introduced that procedure. Do you know if what you’re doing is similar to his new methods?
Dr. Carolyn Delucia:
I don’t know, no.
Charles Runels:
You guys should talk. So you have your study going, is everyone in your study having the same vestibulodynia or do you-
Dr. Carolyn Delucia:
No, they’re having anorgasmia or just vaginal atrophy with decreased sensation. It’s mostly about sensation, as is the O-ShotⓇ. So I think as a combination, these two are going to change the face of orgasmic dysfunction.
Charles Runels:
That’s very exciting. It makes sense that they would go together, combining them already with men. So I know with your study, you’re most likely doing one variable. But outside the study, are you combining this new shock wave with the O-ShotⓇ? And if so, what are you seeing?
Dr. Carolyn Delucia:
I have not yet done it because I’m trying to keep everybody in this study and… Right, right. And I’m actually trying to make them treatment virgins, have no other treatments done yet at all for this study, because I really want to know if it’s this treatment making the difference and the shock-
Dr. Reynolds:
Dr. Carolyn Delucia:
Yeah. And the shocking first endpoint, which I was not anticipating, every single patient… I had two in the study that did have vestibulodynia and even in those, every single patient, the first endpoint was vaginal lubrication. That was their first response, was improvement in lubrication. Anywhere from the second to the fifth treatment, they all had improved lubrication.
Charles Runels:
Interesting. And when do you publish the study?
Dr. Carolyn Delucia:
Well, at this point it’ll probably at six months, we’ll probably finish the data.
Charles Runels:
Just you or are there other people participating?
Dr. Carolyn Delucia:
Nope. Just me.
Charles Runels:
Wonderful. Well, that’s another-
Dr. Carolyn Delucia:
It’s just a little white paper.
Charles Runels:
Yeah. I like it. That’s okay. That’s what you have to do first. Then you do all the sham controls and all that. By the way, talking about controls in the study that I forgot to tell you guys in the study with the hair, they had to be on nothing prior, no minoxidil, no Finasteride, nothing like that. So with your study and I forgot… I just bumped in, if you guys are not getting questions are going like crazy. One of them was PRP devices and other’s a microneedling device. I just put in the chat box the best source I found for reliable rep for a microneedling device. If you have another source, that’s fine, just make sure it’s FDA approved. Back to this device you’re using, Carolyn. What’s the status with its approval? I guess they’re still working on that?
Dr. Carolyn Delucia:
No, it’s FDA cleared for a type one device, which is a massage device, believe it or not. Okay. And that’s what it’s got its clearance for. And they’ve released it. It’s being used now since I’ve been doing this study and had some results out, as soon. As I finished the first set of patients, they started allowing their owners who had already purchased it for men to start using it in women.
Charles Runels:
Beautiful. What’s this orgasmic scale that I have on the screen? I don’t remember seeing that in literature, but maybe… I don’t know. Do you think the scale up or is that in the literature?
Dr. Carolyn Delucia:
No, I made it up.
Charles Runels:
I’m trying to figure out which one of those looks like my fiancee.
Dr. Carolyn Delucia:
I’m sure it’s four.
Charles Runels:
Anyway, so I like that. So it gives a visual for like a pain scale or something and you felt-
Dr. Carolyn Delucia:
Right. Yes. They had come up with one for men. So I came up with this one for the women.
Charles Runels:
Good for you. I love talking with you. What other tips… One of the… Actually, one of the best questions I got, people were texting me questions and they’re too good sometimes to answer on one person. I like to share them and actually wanted your advice on this one as well. So great question. Someone came to my workshop and applies to everything we’re talking about. And the question was… I won’t go word for word, but it was something like, “This was great. I just want to come hang out with you for a couple of weeks and so I can get really good at this.” And I’m thinking, “Well, there are other ways to get really good at it. It may not be hanging out with me. It may be something else.” And I’ll give you my two or three tips about becoming good at these procedures.
You’ve had a decade to think about them and become expert at them to where you’re lecturing worldwide about them. After I give my tips, I want your tips on how… Because there are a lot of new people on the call. We’re up to over 4,000 members in our group now and quite a few new people jumping in now that COVID has slacked off. And the best marketing, of course, is to be very good at what you do. That’s why you’re in demand. You’re good at what you do. And I think the world has become small enough. If someone’s going to up some money, cash money, to get a procedure done, they don’t mind dropping a little extra to get on an airplane. So you’re really competing with everyone, not just the people in your neighborhood when it comes to quality of care, which is a good thing.
So my quick tips are you need feedback. And so one of the thing is, make sure you’re follow… It sounds simple, but make sure you’re tracking everybody down and getting feedback. And the cosmetic work, that means you need a picture before the Botox wears off so you can see what you did. When it comes to the sexual medicine work, means a conversation with the patient and hopefully with their lover, if you have permission or their spouse very soon. I like three weeks and three months as a minimum, and then I can go on and on.
But the other thing I would say is the people who do very, very well in our procedures are all over these websites. When I find someone who’s doing procedures daily, eight procedures a day, eight O-ShotsⓇ a day, seven P-ShotsⓇ a day, I’ll look and they have logged into our membership site 30, 50, 60 times going over… Most people don’t know, it’s like a Wikipedia. We have over 400 videos now on our websites, our membership websites, with transcription so you can search and find almost anything. And they’re in there looking at those to get better. I’m going to stop now. What’s your tips to the new people about how to really become expert, say, in cosmetic medicine, our procedures and sexual medicine. What’s your best tips for the new newbies?
Dr. Carolyn Delucia:
Well, I think the first tip I want to address is how you said they want you to follow you around. Right? I feel that… And I actually had a friend from Europe asking to follow me around in a couple of weeks from now and how much they’re actually going to gain from doing that, I find minimal.
Charles Runels:
So minimal.
Dr. Carolyn Delucia:
So minimal. And I think that when you learn, the only thing you can learn from following another physician around is verbiage, how they talk to the patient and address particular issues. But other than that, you will learn nothing because the only way to learn how to do procedures is by doing them yourself. And so the classic medical way is see one, do one, teach one, right? So I think you need a little bit more than that when I teach the course, and when you teach the course, each student gets several attempts at doing the procedure themselves under direct supervision by you, I, and any of our other teachers in the group. And they have to leave confident enough to do it on their own. However, the key there is being ready to jump right in when they get home.
Charles Runels:
Yes, absolutely true. They have to go when they get home if they wait crosstalk 00:30:51 they’re never going to do it right.
Dr. Carolyn Delucia:
That’s right. That’s right. Because they’ll lose their confidence. They’ll forget a step. “I don’t remember that step. I’m not sure. I can’t do it. Oh no. Cancel that patient.” Right? That’s what happens.
Charles Runels:
Which is why our videos can help with the confidence. But as you’re saying, even if they do a hands on workshop and they go home and they don’t look at the videos until two months from now, they lose… They’re never going to feel more confident than when they first get home. What other tips you got for being good at? I like that.
Dr. Carolyn Delucia:
Correct. Well, number one… Right, they have to schedule those patients before they even get home. So before be prepared, know who you’re going to get on that list. Discount the procedure at first. Be honest with your clients that it’s new for you and that you are learning as well as… You’ll do it again for them if it’s not quite right. You’ll give them even their half price money back or whatever it is, but practice makes perfect. There’s just no other way about it. The others-
Charles Runels:
Add to that discount thing…
Dr. Carolyn Delucia:
Yes, of course.
Dr. Reynolds:
I would couch that with this addendum. I would say, because I’m new at it and I agree… You have to be. You can’t fake it. You have to… Nothing that breeds confidence more than transparency. So you tell them just got back from a class and surprisingly many of your patients will want to be the first one. Am I telling the truth?
Dr. Carolyn Delucia:
Correct. 100%
Charles Runels:
They’re going to fight over the first in line. And then if you want to discount it, do so, but do so with the deal that after this is done, I’ll discount it but would you mind giving me a testimonial or let me use the before and afters. So then it’s more of an even trade and you’re not just somehow saying that because you’re doing it the first time it’s of less value, but-
Dr. Carolyn Delucia:
Exactly.
Charles Runels:
I have to do it that way, but I found that works well. I’m sorry. Keep going.
Dr. Carolyn Delucia:
No, I love that. Testimonials are huge for everything we do. And the other tips is don’t be shy about making videos and using social media. It’s a great way of helping your patients know what you’re doing. So whenever… And you’ve taught me that, is that when you are doing something new in your practice, it’s your job to let your patients know what you’re doing and what you’ve learned. Communication is critical. And even if they unsubscribe to your email, it’s funny how sometimes they will remember it anyway, even though they unsubscribe and a year, six months later, they’re in your office for another reason. And they say, “I remember that email. You talked about some procedure. It was for this.” And you’re like, “Oh yeah, I remember that one. It’s about… What would you like to know?” And then you can then explain what they needed to know about that. And usually they’re going to leave by making an appointment for that new procedure.
Charles Runels:
crosstalk 00:34:22 Acceptable or needed that you teach people what you’re able to do. You could argue that it’s unethical for you not to let them know. If you have a way to make their suffering better and you don’t let them know in some way, then shame on you. Most doctors worry, “Oh, I don’t want to be selling anything.” You’re not selling and you’re really not. If you think about it that way, you’re really not being a good physician. What you’re doing is you’re educating people about all the options are available. One of them is this, whatever the thing is you’re doing. If it’s appropriate I’m offering to do that for you, but we should have a conversation first. And if it doesn’t work, I won’t keep your money.
That’s a very ethical approach to educating your people about their disease and how you’re able to help. And I know she said email and unsubscribing. I still like email because so far, except for MailChimp, no one’s censoring it and Facebook and all the other places. If you’re talking about sex, YouTube even, use Venmo or Vimeo, excuse me for your videos when you’re talking about sex and your email is a personal thing still that’s not censored. So I’ve gotten several questions you mind answering? I’m going to unmute-
Sure.
Dr. Reynolds:
Camille who has a question that has actually appeared. Several people ask the same question. If you don’t mind, Camille, you are unmuted if you turn your mic on.
Camille:
Hello, Dr. Delucia. Thank you so much. And hi, Dr. Reynolds. Thank you. This is-
Charles Runels:
Hello.
Camille:
Great and amazing. My first question is your device a radio device or focus?
Dr. Carolyn Delucia:
It is low intensity. So it’s focused. It’s low intensity focused, extracorporeal shockwave therapy.
Camille:
Okay. All right. Wonderful. And am I only allowed one question? Sorry.
Dr. Carolyn Delucia:
No. Where are you?
Charles Runels:
Camille:
I’m actually I’m Willingboro, New Jersey.
Dr. Carolyn Delucia:
Oh my goodness. It’s called Duo, is the machine. D-U-O.
Camille:
Duo. Yes. And are you able to share the energy settings that you use for the procedure?
Dr. Carolyn Delucia:
It’s 160.
Camille:
Yes.
Dr. Carolyn Delucia:
And it’s 500 pulses in the three locations.
Camille:
Okay. All right. And how soon are your patients noticing a difference?
Dr. Carolyn Delucia:
They are noticing the first endpoint is lubrication and that’s anywhere from as early as the third to the sixth treatment, which is three weeks. Now that’s surprising because that’s not true angiogenesis quite yet. I mean, as far as we understand physiologically, it takes the six weeks before we can see angiogenesis results. So I think it’s simply from the procedure increasing the local blood flow that’s already present without angiogenesis. But that increased blood flow in and of itself is improving lubrication.
Camille:
Okay. Wonderful. Thank you so much.
Dr. Carolyn Delucia:
Absolutely.
Charles Runels:
Yes. So guys, I put… Thank you very much.
Camille:
You’re welcome.
Charles Runels:
I put in the chat box a link to Carolyn’s next class. She lectures a lot from the stage, but she’s agreed to do another class. We’ve got lots of requests and she’s doing one in January. As you can tell, she’s been successful financially. She’s developed a deep understanding from the business side and the medicine side of it. So couldn’t go wrong with her class. I put a link to that there in the chat box. If you click, it will be open when we shut this down. Let’s see what other questions we got? I don’t know the answer of the telogen fluvium question. I’m sorry. I know that alopecia areata it works well for, but I don’t know that answer to that one. So is a linear… Another question is linear and equivalent term for low intensity?
No.
Okay. Talk to me.
Dr. Carolyn Delucia:
Linear is again, radial. Linear is what we are accustomed to seeing. The linear extracorporeal shockwave is the stores or the Zimmer type machines. They can only penetrate 1.5 centimeters versus the 13 centimeters. The focused low intensity goes into the body into the tip of a cone, if that’s making sense. So it starts out wide and narrows at a depth of 13 centimeters, the radial or linear type of shockwave that we’re more accustomed to is only penetrating 1.5 in an outward cone. So the intensity of the pulse is right at the surface of the skin and then radiates outward.
Charles Runels:
Interesting. So postulating why that’s working is a fun mind exercise. And I can’t wait to, well-
Dr. Carolyn Delucia:
It’s working because it creates bubbles. It’s creating bubbles.
Charles Runels:
Who knows what else it’s doing, right? I mean, it’s doing that but what else it doing? It’s increasing local blood flow, angiogenesis, but what’s it doing to the actual muscle? Maybe there’s other things happening with the pelvic floor as well. So let’s see. Carolyn, do you have any other tips? I’m going to swap back to hair for a moment. You’ve done all the procedures and you’ve done the cosmetic work as well, quite a bit. Any pearls about how you’re doing your hair procedures?
Dr. Carolyn Delucia:
Well, my biggest pearl is pain management. I think that it can hurt. And one of the skills that you must develop whether you’re microneedling or injecting, which I usually inject and then do a little bit of microneedling on top and sprinkle the rest of the PRP, but the key is being fast, being efficient and fast.
Charles Runels:
So fast. At normal speed, how long does it take you to do a scalp? crosstalk 00:41:30 It’s a short time, because it’s short isn’t it?
Dr. Carolyn Delucia:
It is short, yeah. It’s five minutes. But I do it Pro-Nox, with Pro-Nox.
Charles Runels:
All right. Any other tips about how are you… I’m still doing point injections. The thing about the microneedling I’m wondering what would I do with an Italian woman with that thick black hair? If I’m doing microneedling crosstalk 00:41:54
Dr. Carolyn Delucia:
No. Only around the temples, only in small areas where you can get to where it’s really thinning, only where it’s thinning maximally. Otherwise I agree with you, there’s no way. You won’t get… No, no.
Charles Runels:
So now I have… Wait a second. Jason says he loves his Duo with the O-ShotⓇ. I’m going to unmute you, Jason, and you can elaborate on that.
Dr. Carolyn Delucia:
Jason.
Dr. Reynolds:
Hold on a second. Let’s pull Jason on here. So he is combining them. I want to know what pearls he’s got for how he’s combining the two. You’re unmuted Jason, share some wisdom.
Dr. Carolyn Delucia:
Unmute on your end, Jason.
Charles Runels:
I just send him a thing that hopefully can click on it. There you go. You’re alive.
Jason:
Let’s try that. Is that better?
Dr. Carolyn Delucia:
Yay.
Jason:
So we actually just finished our first set of patients with the Duo. We bought it the beginning of September after one of Carolyn’s lectures, actually. And our first patient wanted both, which was awesome. So she’s about six weeks out at this point and absolutely loves it. We use the same scale, the orgasmic scale, from Dr. Delucia and she went from a healthy three to a five, easily. She says she’s getting better results than she did as a teenager.
Charles Runels:
That’s wonderful. What’s your tips? So did you do both procedures the same day, shockwave followed by PRP? Did you separate? How did you combine the two?
Jason:
So I decided to do the O-ShotⓇ later. We did the O-ShotⓇ after the series on the Duo mostly because I wanted ultimately the maximum amount of damage from the Duo.
Charles Runels:
Makes sense.
Jason:
And that way didn’t risk any loss of the PRP theoretically.
Charles Runels:
I like it. So the new cell growth would not be disrupted.
Dr. Carolyn Delucia:
Exactly.
Charles Runels:
So you waited to the shockwave. Very smart. Waited to the shockwave was… Here’s the thing, just as a side note guys, we’re still… All these new technologies are so new and they all make sense. It’s just not like we’re doing… We’re not waving crows feet and saying incantations over a fire. These all have strong histological, biological things. With the PRP you have over 14,000 papers on PubMed and shockwave’s been around forever. But how to combine them together is still largely what we’re doing now, sharing notes. So pay attention because here’s a guy who’s done it and is telling you how he did it. So you did the whole series of shockwave with the idea, and I agree with you, with the idea that had you thrown the O-ShotⓇ into that mix you might have undone the new cell growth with a shockwave the next day or something.
Jason:
Well, and because if I’m going to increase healing, I want to get my damage done first. And so that was kind of the thought process there. We do a lot of vaginal rejuvenation. We always do our O-ShotsⓇ after just because it… Again, I’ve done… So we do Morpheus eight as well. I’ve done topical and needled in with the Morpheus eight. And I find that if I do that, I actually destroyed the PRP. I don’t get as good as results.
Charles Runels:
Makes sense.
Jason:
And so anytime I’m adding energy, I use my PRP afterwards. And so with the P-ShotⓇ, I would do it after my shockwave, the O-ShotⓇ, same thing.
Charles Runels:
Love it. And so you’re also combining the P-ShotⓇ with shockwave and you’re doing the full series of shockwave and then following with a P-ShotⓇ, correct?
Jason:
Correct.
Charles Runels:
Yes. Interesting. Sounds like you’ve been successful. You and Carolyn have a little conversation, if you don’t mind, about how… Someone comes in with erectile dysfunction. Jason, you go first. How do you talk to them about the different options? Or do you have a menu? How does that conversation go?
Jason:
I usually start with, what are your goals? What do you want to see happen? Once we’ve kind of defined the problem, we go into what they want to have happen before I even pull out options. If It’s I want to be a little harder, I want everything to work like I was 20 again, whatever that is. And then I will actually ask them what they’re willing to do to make that happen. How important is this to you?
Charles Runels:
So you say, “What are you willing to do,” after you give them the menu? Or you’re just asking them what’s your priority?
Jason:
Beforehand, yeah.
Charles Runels:
How important is it?
Jason:
Because that’s really going to decide what I can do for them. If they say, “Well I pay a couple hundred bucks for it,” they’re not on my patient because I’m never going to get good results.
Charles Runels:
Yeah, you want to do whole treatment. You’d lose money.
Jason:
And if they say, “Hey, I’ll sell my car. What do I have to do?” Then we’ll go through, “This is where I start.” I either go this way or this way. I go P-ShotⓇ or shockwave. Those are kind of my go-tos at this point. Personally, I add in some pharmacologists… Sorry that one’s hard for me to say. Some medicine to help and we go from there. I tell them the best results are when we combine everything. And then I have a center protocol that I use with medicines, with the pump, with the P-ShotⓇ, with the shockwave and we go through that whole thing.
Charles Runels:
You got something to add to that, Carolyn? Thank you very much, Jason. I like that. Actually, one of my favorite questions is “If I had a magic wand, what’s the one thing you want me to make better?” Whether I’m doing cosmetic work or in health as an intern. What’s the thing that if I were just omniscient and omnipotent, what would you want me to do? So I like your question. Talk to me, Carolyn. How do you do these conversations? And then when you’re done. I want to remind people of some research and get your comments on it. We covered in the last journal club about some new research about urinary incontinence with the O-ShotⓇ. And I want your thoughts about it, Carolyn, after. But talk to us about your conversations first.
Dr. Carolyn Delucia:
Well, when I speak to men out their issues, I want to know what they’ve tried so far. In addition to what their goals are, what have you tried so far? What kind of results did you achieve? And then I will also ask if they’ve had any blood work because I think that testosterone levels can play a role as well. So the whole picture, do they have cardiovascular issues? What’s their overall health look like? What kind of activities do they do? How active are they? All of their physiological health is important as well because their blood flow, it’s all about flow, 100% about… Blood flow and nitrous oxide, so that’s what we want to make sure that they are able to accomplish. So once I have that understood, then we can decide a plan. And just like Jason said, I would use the Duo, which is really showing great results. And always the Priapus Shot® and hormones, if needed, and of course Cialis, if they need it or any of these pharmaceuticals.
Charles Runels:
Yeah. I think this whole idea of having to tip toe around it, Jason mentioned, would you be… When people will say they’re willing to sell their house, that’s a good sign. And I agree with that. That’s the sort of motivation you want because it’s not just about money. Are they motivated to do the things you’re going to ask them to do to come crosstalk 00:52:28 follow the protocol. But really what it comes down to most of what we’re doing, it’s about the price of a transmission repair. And I like putting it in those terms so that people realize if your health and your marriage is not worth the price of a transmission repair, my cost of goods is going to be more.
I might treat you if you have zero money for free, but if we’re going to have a fair exchange, my cost of goods is going to be sufficient, high enough that I can’t… You got to be willing to spend a transmission repair or a new set of tires for a nice car kind of money or we just can’t play. I wanted to pull this up again because we’re running out of time. Thank you, Jason, for jumping on. I don’t know if you were on the last call, Carolyn, but if you were, I didn’t ask your opinion. But I’m really super stoked about this research.
Dr. Carolyn Delucia:
Yes.
Charles Runels:
That came out.
Dr. Carolyn Delucia:
Yes, I was on. Yes.
Charles Runels:
Yes. And so talk to me about what’s your thinking about…
Dr. Carolyn Delucia:
The multiple sites?
Charles Runels:
Yeah, the whole thing. The protocol, what’s the next step? Tell me what you think when you read this paper.
Dr. Carolyn Delucia:
Well, first of all, it’s evidence, once again, that PRP works. Thank God.
Charles Runels:
crosstalk 00:53:50 And is such a strong paper.
Dr. Carolyn Delucia:
Yes. So that’s the biggest take home message is anytime that I see PRP in a clinical trial where it’s published in a reputable journal and it’s proving what you’ve been saying all along and what we have been seeing anecdotally all these years.
Charles Runels:
Yeah, it’s a decade.
Dr. Carolyn Delucia:
Yeah. It’s life changing and something so simple without surgery. So I think that’s the biggest thing. I think that multiple… Just like you said when you had the discussion last time, doing multiple injections, to me, doesn’t really make sense. And even if you… When you make a stick accidentally and you go through and then you get it in the right spot, some of that PRP will leak out of the hole you made.
Charles Runels:
Yeah. crosstalk 00:54:54 injection points, right? It’s like a-
Dr. Carolyn Delucia:
It doesn’t make sense because you’re going to leak it out. It’s almost better to get it right the first time and get the bump that I love to feel in the front anterior vaginal wall. I know I’ve made, it’s all there. It’s got that whole four cc’s right where we want it and it’s activated and it’s going to do what we want it to do, create that new tissue around the bladder neck. I feel that the multiple sticks, you’re not putting in as much PRP where you really want it to be.
Charles Runels:
That’s a good point, because it’s going to be, and it does happen. It leaks out just from the pressure when there’s a hole there. I’m so grateful that you’re on the call. Just to remind you, Carolyn got a class coming up. But if you go to that website and it’s also got her contact info and you can tell, she knows her business and she loves to teach. Also, I put a link in the chat box. If you click on these, they’ll be open when I shut this down in a moment. If you don’t, they’re going to disappear. I have Dr. Petrillo 00:56:12, orthopedic surgeon, is going to be teaching this along with me at my office. If you’re doing anything to do with weight loss and women’s hormones, as you know, many of them have knee pain and it pays well and it changes lives when people can walk again. So we’re doing this class in the beginning of January. So thank you, Carolyn. Excuse me. It’s beginning of December.
Dr. Carolyn Delucia:
Thank you.
Charles Runels:
I’m so happy to catch up with you and hopefully I can see you in Chicago. That’s a business class, right? That you’re teaching in Chicago?
Dr. Carolyn Delucia:
Yes. That is a Alma business of beauty, they call it.
Charles Runels:
What’s the website on that, because people might want to check into that too? What’s the website on that one?
Dr. Carolyn Delucia:
Oh, I-
Charles Runels:
It’s okay. I’ll throw it in the email when I send it out. Thank you guys crosstalk 00:57:06 the call. Thank you, Carolyn.
Dr. Carolyn Delucia:
Thank you.
Dr. Reynolds:
You have a good night. Okay. Bye bye.
Dr. Carolyn Delucia:
Bye.
References
“Hamilton–Norwood Scale.” In Wikipedia, November 1, 2021. https://en.wikipedia.org/w/index.php?title=Hamilton%E2%80%93Norwoodscale&oldid=1053075578.
Ozcan, Kubra Nur, Serpil Sener, Nihal Altunisik, and Dursun Turkmen. “PRP Application by Dermapen Microneedling and Intradermal Point-by-Point Injection Methods, and Their Comparison with Clinical Findings and Trichoscan in Patients with Androgenetic Alopecia.” Dermatologic Therapy n/a, no. n/a. Accessed November 2, 2021. https://doi.org/10.1111/dth.15182.
Next Hands-On Workshops with Live Models<---
–>Apply for Further Online Training for O-Shot®, P-Shot®, Vampire Facelift®, Vampire Breast Lift®, Vampire Wing Lift®, or Vampire Facial®<–
–>Next Hands-on Workshops with Live Models worldwide <–
Cellular Medicine Association
1-888-920-5311