JCPM2024.09.24

The following is an edited transcript of the Journal Club with Pearls & Marketing (JCPM) of September 24, 2024, with Charles Runels, MD.  

>-> The pdf of the transcript of this live journal club can be seen here <-<

Topics Covered

• Injecting testicles with PRP to increase sperm counts
• The Infringer Trap: a free service to our members, a nightmare to those who steal from us and trick patients.
• Increasing Penis Girth Combining the P-Shot® Procedure with HA Fillers
• Free Software to Calculate Female Sexual Function Index (FSFI) and Why to Use It
• References
• Helpful Links

Charles Runels, MD
Author, researcher, and inventor of the Vampire Facelift®, Orchid Shot® (O-Shot®), Priapus Shot® (P-Shot®), Priapus Toxin®, Vampire Breast Lift®, and Vampire Wing Lift®, & Clitoxin® procedures.

Transcript

Charles Runels, MD:

Welcome to our Journal Club. You are in for a special treat today. I was surprised to receive a message from Dr. William Song, who’s been in our group for a long time. I can’t remember when he was not in our group. Not only is he an excellent internist, but he became an excellent teacher and provider of cosmetic procedures before I ever met him.

And he took our P-Shot® to a different level with his technique for expanding the circumference of the penis with HA fillers.

He taught me how to do that, and I’ve experienced firsthand that it’s effective and wonderful. I’ve also talked to quite a few of our providers who’ve been through his course. So, we’ll have him on very shortly.

Injecting Testicles

I wanted to share one quick paper with you before we start with Dr. Song regarding the injection of the testicle.^[1] 

We talked about this in a rat model probably three or four weeks ago.^[2] There’ve been other studies on rats, but this is the best. He mentions another hint of a study, but this is the best study I’ve seen. I think the landmark study will probably use platelet-rich plasma, injecting the testicle to improve fertility rates.

Now, when I saw it coming out or talked about in rats, my first thought was, “Well, that’s obviously something that’s needed.”

For at least the past five years, a growing number of papers have been about injecting the ovaries. Now, every week, there’s at least one, usually two or three papers about injecting the ovaries or injecting the endometrium to facilitate fertility in women, especially postmenopausal women.^[3]

Ten years ago, I injected my testicles. They give you their way of doing it. I’ll tell you how I did it a couple of times. It’s not a big deal. It sounds horrible, but it’s not a big deal.

Anyway, one of the things that occurred to me is that men on testosterone who have testicular atrophy might help with changing the size of the testicle. 

And they demonstrated that that did not happen in their group.

They were divided into two groups. The only difference between the two groups was whether they had failed previous attempts at this microdissection testicular sperm extraction, which I’ve never done. Still, maybe some of you are familiar with it.

The results were promising, and one of our providers texted me about trying it with one of his people to help with the size of the testicle. He also did not see a change in size. As a matter of fact, initially, the man thought his testicles got smaller.

But if you look at their method, they used 20 CCs of PRP and did what amounts to a double centrifuge, giving a supernatant of two CCs of PRP.

And they don’t have diagrams of how they did the injection, but if you look at the description, I think it’s funny because we talk about injecting the… Let me pull it up for you. Some of these people had chemotherapy. I had a friend in high school who had Hodgkin’s disease, and it’s one of the things they did was bank sperm before they treated him. So, this is a common thing that is more common than we know about because it’s not something people talk about on Facebook.

As with the other soft tissue studies, we always talk about the full effect of our O-Shot® and P-Shot® on the face around the third month. And that’s what they saw here.

When they followed up, it looked like the effect was less after three months, at least with this procedure.

They used local or sedation and targeted the seminiferous tubules or the interstitial space. That was the part that made me chuckle because, I mean, you’ve already thought about this. But if you look at the testicle and come in from this side, which is what I recommend, you can palpate it very easily.

This is what I did. I took a 27-gauge needle and cleaned things off with some Betadine. And there’s a side where you can feel the epididymis, and then there’s a side where it just feels like there’s an egg there. It’s not a small target. And so, you can appreciate its size. You’re holding it in your hand, and so the size of it and estimating going with your needle from there to someplace towards the center of that egg. I think could be done blindly, but whatever.

Urologists like to play with their ultrasounds.

They used an ultrasound to ensure that they were in the interstitial space or not in the seminiferous tubules. In other words, they needed an ultrasound to ensure that they hit that ball right there. But that’s okay. I have toys I like to play with, too, but I had to chuckle at that degree of needing to use your ultrasound machine. But I guess it’s a study, so you must do that.

I want you to know about it. I haven’t seen any other good studies about it, but I think this will eventually become the standard of care. And if you are working with women who are trying to get pregnant or with men, I think you should know that, to me, what they’re suggesting is that, well, if you look at their conclusions, it will soon become the standard of care.

And if I were trying to get my wife pregnant and had a low sperm count, I think this would be the standard of care tomorrow.

But again, with everything we’re looking at here, there is no set finish line, and nothing is ever proven.

I think it’s a misconception that we think something is proven. It becomes more and more widely adopted as the research mounts, but things stand until someone disproves it. There’s never a discrete finish line this is now proven. I suppose something simple like the world is round when you fly a rocket up into the air and look at it.

But science, that’s a standard frustrating thing about pushing research forward is a lot of times, the finish line is not noticed.

As Pascal said, “Science progresses one funeral at a time.”

And I think with that, I’ll stop and let’s get Dr. Song on the line.

The Infringer Trap

Oh, before I do that, I made a note to remind you about something that’ll take a second.

This website.

I call it our “trap” to make it easier for me to remember the website where it is.

CellularMedicineAssociation.org/trap

We use a company called BrandShield, which some of you know about but some of you don’t.

We set up this form tied to software that communicates with BrandShield.

They took down around 22 websites last week. They’re averaging 1.6 websites per business day for the past year. Well, you can see that we’re a small account. The companies that use them are huge. Their specialty is making websites disappear when someone is illegally using intellectual property, which happens quite a bit.

Surprisingly, many physicians take pride in their ability to steal intellectual property. People who would never steal a nickel pack of gum want to blink at doing that. So, if you see someone advertising our procedures and they’re not on the directory, you can call or email us, but the quickest way is to go here and fill out this form.

When you fill that out, our software hands off the information to BrandShield, and then BrandShield communicates with the person one time. If they don’t take it down, their next step is to go to the internet service provider, and they will make their social media account or their website disappear.

Sometimes it’s a few days, sometimes it can be a few months, but we eventually get them.

So, when people sometimes think that the reason for being in our group is just being in the directory. But this is a million-dollar budget item for us. And without it, you would have people advertising P-Shots® for a hundred bucks, doing whatever they wanted to because you could call some cosmetic procedure at the makeup parlor a P-Shot® if you wanted to. The tattoo artist could call something a P-Shot®. The only thing that gives it quality is we’re spending a million dollars a year to run off people who try to steal the name.

And I don’t worry about it. I take pleasure in it because they’re hurting the group when they do that. And that’s all you have to do.

So, I wanted you to see that. Some of you don’t know that it exists. And if there’s a place to put in your info if you want to be contacted about the progress. If you’d rather do it anonymously, you can do that too.

Increasing Penis Girth Combining the P-Shot® Procedure with HA Fillers

Okay, let me pull Dr. Song on the line so he can show us all about how to make the penis thicker with an HA filler. Here he is.

Hung William Song, MD:

Hello.

Charles Runels, MD:

There you are. Hey Bill, how are you doing?

Hung William Song, MD:

Hey. How are you? Thank you for having me on.

Charles Runels, MD:

Well, thank you for making time to be on the call. Tell us a little about your background.

And if you want, more about why this topic is important. I don’t know how many of you have been in the P-Shot® business for a long or in urology family practice and have seen a man with a two-inch erection or a three-inch erection. And it can be disturbing for them. And pressure on the anterior vaginal wall contributes greatly to pleasure. I try to comfort them by telling them that 10% of women are lesbian. They’d rather not have a penis at all in the room. And many are completely happy with and have trouble fitting even an average-sized penis.

But it’s still handy to be able to make the width. Even if you can’t do a lot with length, if you can make the width change, it can dramatically improve sensation because of that pressure. The touch sensation, the gynecologists know you can do surgery on the vaginal wall. There’s almost no sensation topically. It’s pressure on the urethra and the clitoris; it runs along the pubic rami stretch. It gives pleasure more than touch. So, some change in volume is significant, and it doesn’t take much for it to be able to tell the difference.

Hung William Song, MD:

We’ve been talking about this for years. I know that you had been suggesting that I put together a course. I’ve been holding back a little bit because it’s a simple procedure for people who are comfortable doing injections in that area. But then some people really aren’t skilled medically and aren’t prepared to do these treatments. And if they do it wrong, they give the whole thing a bad name.

In fact, there was a local physician that was doing a penis enhancement and landed somebody in the hospital. And he ended up losing his license, mainly because of other unscrupulous things he was doing. But the point is that he probably wasn’t properly trained. I suspect he probably tried injecting fillers into the corpus as we do with the P-Shot® [but we use PRP for that, not HA, which is safe].

 And that’s the biggest mistake that I want to make clear to everybody is that you do not inject fillers into the corpus. 

We inject PRP [into the corpus cavernosum]. But, when we use fillers to augment the girth, we inject beneath the skin in various planes outside the vascular tissue [not into the corpus cavernosum].

Anyone trying to do this needs to know this right off the bat for safety reasons.

And then there’s the whole aesthetic aspect of it. So, we’re injecting fillers outside the vascular tissue. The trick is to do it in a way that you don’t want to overfill it because if you overfill, it starts to look abnormal. In fact, one of the most common things is that if you overfill it, it starts to look mushy and out of shape. And you can even have a circumcised penis start to look uncircumcised, and people don’t like that.

The other things that we need to watch out for are nodules and lumps, as well as pigment changes. And sometimes, you can even get skin necrosis.

Those are nodules from PMMA.

They can be treated. Treating those PMMA nodules is tricky, so I recommend using hyaluronic acid. Hyaluronic acid fillers are reversible and can give great results.

So, this is an example of somebody who came to me. Somebody injected silicone. They did a bunch of things to him. You can see above in his symphysis pubis area; they did a suspensory ligament ligation, which failed and caused his penis to retract.

Then they injected silicone into him and had disastrous results, and tried to dissolve it using steroids. And then it got atrophy. So, this was kind of a case of this procedure going wrong.

I was able to correct it for him, but it took nine treatments over four years. We used PRP, stem cells, and fillers to regrow the tissue and make it look normal.

Charles Runels, MD:

Beautiful result.

Hung William Song, MD:

Yeah, we don’t want to have to do that. This is a common thing. When you inject too much filler, it compromises the blood supply and makes it prone to getting some of these ulcers. So, injecting it over multiple sessions slowly is the trick to avoiding this. And combine it with PRP to help grow natural tissue around the fillers.

This is a picture of a male with the skin around the distal end of the penis grown over the glands, making him look kind of half circumcised and half uncircumcised. So, we want to try to avoid that, so we try not to inject too close to the distal end.

The next slide shows an example of the filler migrating and bunching up in the middle. That’s also an undesirable outcome.

Hyaluronic acid can be dissolved if it’s used.

The next one is hyaluronic acid. It looks overfilled and pillowy, and it just feels unnatural. It feels very soft, even when it’s erect, so that’s another undesirable outcome.

So, this one has too much filler distally.

It takes away that little ridge that’s formed by the glands. So, when you’re having intercourse, you lose that friction. Now when he’s erect, it’s better, but if the girth, especially at the distal end, is too uniform with the glands, then the penis just kind of slides in and out without the friction. So, those are some of the things you want to avoid.

Some people say you can’t treat uncircumcised penises, but I treat them all the time. I think it’s a little bit easier because you can make it look pretty big without making it look too unusual.

Here’s a patient over time.

So, we can grow the girth, and we can grow the flaccid length. So, it does look longer. It’s not erect, but because of the weight, it hangs longer; they can feel it. And it just gives men a lot of self-confidence when they can feel the weight and the girth of the penis.

Charles Runels, MD:

I don’t know if people know, but you’re the first person I’ve seen teaching that knack of mixing the HA with PRP.

Lots of people are talking about this procedure now. They weren’t when you started doing it, but many are now. But I still have only heard you talk about teaching it in such a way that you’re mixing the HA to give a smoother result. And I’m sure it’s also helping prevent some of those problems with ulcerations you were talking about.

The other thing is that combining this with our Priapus Toxin® procedure, which also increases the flaccid length by enhancing the parasympathetic system, I have seen those two work very well together.

Hung William Song, MD:

Yeah. In fact, I got into doing this in the first place because after I learned the P-Shot® from you. When I was treating patients, a lot of patients asked about size enhancement. I tried to downplay it, but some people really got fixated on the size and started to research if there was a way that we could use fillers to get a better increase in size. So, that’s how I started doing this.

Mixing the PRP [with the HA] helps collagen form.

One of the previous pictures showed how mushy and soft the filler can look. When we combine it with PRP, we’re growing natural tissue around the fillers. So, if you look at this picture, you can see that it’s not mushy looking. I mean, it’s a little bit softer, but it’s much more of the natural skin and collagen rather than just fillers.

Charles Runels, MD:

I know the light’s not the same. Yet, the tissue looks healthier. There’s an increase in rubor from the neovascularization.

Hung William Song, MD:

Yeah. We also find that the pigment improves.

Charles Runels, MD:

I can see that. It looks like a healthier penis.

Someone texted me today, and I told them to be on the call tonight because I wanted you to answer it. They asked about it after someone had had this procedure, and then they wanted to repeat P-Shot®. Is there any knack for that?

Let’s say this guy comes back a year from now, and he’s happy with shape and size, but he wants to another P-Shot® for better erections. What are your rules for that?

Hung William Song, MD:

Yeah, he can absolutely have as many P-Shots® as he wants.

It’s not going to interfere with it. The only thing to be aware of is if somebody who’s had the procedure wants to use a slightly longer needle. Sometimes, if you’re using a little half-inch needle, it might not reach the corpus. So, you might need a slightly longer needle, but there are no issues with doing a P-Shot®.

Charles Runels, MD:

What would you say, if one of your patients was considering this versus one of the implants, the sleeve?

Hung William Song, MD:

Yeah, so it’s like a Penuma implant. Well, the advantage of this is, well, one, it’s not surgery, so you don’t have to physically cut and open anything. It’s still all done with needles.

And, as I mentioned before, you’re building natural skin rather than putting a foreign substance like an implant in. The fillers act more like a scaffold with your own collagen and vasculature forming around it. So, you don’t have the risk of it extruding or causing issues with having an implant in there—less risk of getting scar tissue and things like that.

Charles Runels, MD:

Right. I was just going to add to that because there was a picture going around a couple of weeks ago that seemed to be getting passed. Several people texted it to me, so it went viral for some reason. But it was an X-ray of someone showing an HA filler that had been put recently into someone’s face. And it’s crazy-looking in the picture.

But it goes back to before Juvéderm was even approved in the U.S.; the Restylane people did a study demonstrating what you just talked about that even without adding the PRP, as the HA is absorbed, it does not go back exactly all the way back. There’s new collagen production from the HA acting as a scaffolding. And, of course, when you add in the PRP, there are multiple wound care studies talking about that mixture causing neovascularization and collagenesis with the actual growth of new tissue.^[4] 

Yeah, if you do an X-ray the day after you inject it, you’re going to see something. But if you did some visualization of this penis, not saying you wouldn’t find any HA, but you would find a lot of just actually new tissue that’s grown because of that mixture.

Hung William Song, MD:

Yeah. If you use this technique to combine it, if you have dissected it, you won’t find pockets of filler. It’ll be around real tissue. I think we saw this one already. So here, this is not really a complication, but one thing is sometimes when you do, it looks a little too smooth, so it doesn’t look as natural. So, I develop ways to use these fillers to create little fake veins to make it look more natural

Charles Runels, MD:

Ah. Artist at work. Beautiful.

I haven’t seen those pictures. You haven’t shown these to me yet. Yeah, it looks like he’s got a little vein there. Very cool.

Hung William Song, MD:

Yeah, so we can do little artistic stuff with it.

And here, it’s just showing again how the flaccid length can be nicely increased. So yeah, it’s not as wrinkly, even when it’s flaccid. That’s one of the things you’ll notice after the procedure.

Here’s another guy who had a suspensory ligament ligation. I’ve seen so many things go wrong with it. He felt that it retracted after the surgery. You can see he’s got a lot of scar tissue there. He felt that it retracted more after the surgery, so we were able to fill that back up and let it hang a little better.

Charles Runels, MD:

Yeah, that’s a beautiful result. Are you still using your ultrasound to supplement your work?

Hung William Song, MD:

Yes. One way to avoid the nodules, which are the biggest issues, is to use it in combination with the PRP and shockwave.

Use the ultrasound to smooth and set everything.

So, the HA fillers are really the best way to go.

Some people say that you need to use the Voluma and the big volumizing fillers.

I like regular Juvéderm, Versa or Restylane. I think the Versa works best.

Then, I hyper-dilute it even more because I don’t want it to be puffy and pillowy. So, the fillers will give you great results. And because they stimulate collagen, you’ll get longevity.

Now, I do sometimes use collagen stimulators like Sculptra and Bellafill. But these are really for after you’re really experienced because they’re not as forgiving.

If you get a nodule with these, it’s much more difficult to treat. And here are the tools that we need: cannulas and needles, PRP, Acoustic Wave, nothing really…

You don’t have to buy a $200,000 machine to do this procedure, and the return is remarkable. I mean, these are treatments that people are happy to pay for, so it’s a very, very profitable procedure for us. And it’s kind of a little niche that I’ve found.

Charles Runels, MD:

Well, you’ve been successful at it for a good reason. I know when you were first doing this, you put a lot of time and research into figuring out the best technique. And now you’ve been at it for how many years? Seven, six? How long?

Hung William Song, MD:

Yeah, I think eight or nine years.

Charles Runels, MD:

Yeah, yeah. So, it’s been a while.

And I’ll just caution everybody, you think, “Oh, you just do subdermal. I can do it in the cheeks; I can do it in the penis.”

Not really, because from having done it, there are a lot of ways you can wind up with something that’s deformed. And here’s someone, they must go home to their wife now with this deformity or their girlfriend, boyfriend, whatever, and they don’t like it.

So, it’s worth it. I invested, and I paid; I wanted to pay. I paid full price for Dr. Song’s course and didn’t regret it. It was worth every penny.

So, tell them how they can find out. I’ve been encouraging Bill to do an online version. I don’t think it’s something that can’t be taught with a video, but multiple videos and lots of pearls.

I’ve resisted teaching it in my courses because I think it deserves its own thing. And because I haven’t done as much of it as you have, I don’t want to teach something if I know someone else can teach it better.

There’s been demand for it, but as you know, I’ve resisted teaching this and sent everybody to you. And I was excited to hear that you did an online version. It’s not going to be a two-minute video. And they got it down. Right?

So they have lots of warnings and pearls and tips about how to use that shockwave device and how to do the injections. I’m plugging it because I know the temptation to go try this on your own.

 Just don’t.

Hung William Song, MD:

Thank you so much, Charles. I think the people in this group who’ve been doing P-Shots® are going to be fully capable of doing this procedure.

It’s the people who are too cheap to take a P-Shot® course or pay the monthly membership. They’re the ones who take half the information and try to do it themselves.

So, I have online and hands-on so that depending on what you’re comfortable with, if you’re comfortable watching a video and being able to do it, then you have the medical skills to do it; I try to put as much detail into it as possible so that you can do the procedure safely.

And I think that’s the most important thing too, do it safely. And on the online course, I only teach the hyaluronic acid because you can’t really get in too much trouble if you follow all the instructions if you’re using HA fillers.

It’s when people use permanent fillers that they run into trouble.

Charles Runels, MD:

20 years ago, I heard Dr. Obagi say, “Permanent good is also permanent bad.” 

And I thought, “Here’s the freaking godfather of cosmetic dermatology.”

And if you remember, well, I don’t know if you’ve ever heard him lecture; he’s a wizard. And when he talks about doing chemical pills back in the day, deep pills under general anesthesia stuff, that would terrify me, but he would not use permanent fillers.

And I want to re-emphasize what you said. HA, you get a little hyaluronidase; you can always be done with it. But put some Bellafill in there, and if it goes wrong, you have a problem.

Hung William Song, MD:

Yeah. So I feel much more comfortable putting out the online version, teaching the hyaluronic acid fillers.

And with some of the new techniques that I’m teaching on this, I think you can get some nice, long-lasting results with the hyaluronic acid fillers. The nice thing about the hyaluronic acid fillers is that besides the safety, they do last, but they do come back. I have patients who come back every year or every couple of years for a little top-up.

So, it’s a nice recurring revenue stream. It’s not like they get it and then disappear. They’re your clients for life.

Charles Runels, MD:

Are you teaching the shockwave part as well?

Hung William Song, MD:

Yeah, yeah.

Charles Runels, MD:

Good. Good, good, good. Because I know a lot of the people on this call already have the shockwave machine. Other than a PRP centrifuge, if you’re going to buy a machine, that’s the best return on investment, if you consider the cost on them and someone else can drive it. So, that’s good. So, you tell them how to work that into the procedure, too.

Hung William Song, MD:

Yeah, so that’s there. And I made the price points for the online less than what you would charge to do a full enhancement on one patient.

Charles Runels, MD:

That’s kind of my guide point. If you can make your money back with one patient, it’s pretty much a no-brainer. And so, thank you for being on the call.

Let me see if anybody has a question.

I see a few questions. Let’s see this.

I have another website I want to give you that could be of help to you, so don’t go away. But let me see what questions we got first.

Okay, so someone said thank you, and another person said thank you. Jessica said she missed the answer. How long do you have to wait after the HA before the PRP shots?

You could do them the same day, right?

Hung William Song, MD:

Yeah. You do it at the same time. You do it at the same.

Charles Runels, MD:

So they could come back, have it that day, Jessica, or come back whenever. You have to be careful about depth. You can feel it go through the fascia, so as you heard Bill say, you have to make sure you have a needle long enough.

Let’s see what else we got. James says, “Does it change the strength of the erection?”

Hung William Song, MD:

Yeah. So, if it’s overfilled, it will change the strength of the erection.

And that’s a challenge. People keep coming back wanting more and more, and I must tell them it’s enough. It’s almost like the lip fillers: Some people want more and more, and it starts to look weird, and you have to really tell them to stop. So they love it, but you have to tell them it’s starting to look abnormal now.

We got to stop because of a couple of things. If you really feel it too much, it starts to compromise the blood supply. So, it’s more prone to getting ulcerations. It’s going to interfere with their sexual activity because it’s going to be too thick and not as functional.

And they’re not going to enjoy having intercourse as much because it’s not as stiff.

So, if you do it in the appropriate amount, it’ll really enhance their pleasure. But if you do too much, it can have a detrimental effect.

Charles Runels, MD:

Someone asked about using it to augment the glands. I pulled some of those studies up, but they’ve seen most of them already.^{[5] [6] [7] [8]}

What’s your experience with that idea?

Hung William Song, MD:

It’s been used a lot overseas in Asia and in South America to enhance the glans. It’s a great treatment for premature ejaculation because it decreases the sensitivity.

Now, a couple of things within putting it in the glands, I always felt a little uncomfortable about doing that cause vascular tissue. So, even with HA fillers, I’m just afraid that some of it will get into the bloodstream. So, the glans can start to look a little crinkly and not as smooth. It has been done, but I don’t really recommend it. I rarely do it on my patients.

And you must warn them it is going to decrease the sensitivity. If their problem is premature ejaculation, then it’s a good treatment.

You want to be very superficial. The catch is that if it’s superficial, it’s more likely to be bumpy looking. But if it’s deeper, you risk putting it into the vasculature. So, we want to make sure it’s very dilute [using PRP] so that you don’t get the bumpiness.

Charles Runels, MD:

And I don’t know what your experience has been, but I think to make the glans enlarge enough to match the work you did with corpus cavernosum, you would have to do some risky stuff. You can make it to where it’s noticeable, but you can’t augment it to the same degree as you can with the shaft to match it.

So, someone else, it looks like maybe they missed maybe the front of what we’re doing. You wouldn’t put the PRP with the HA on the outside. It wouldn’t really do much because the PRP, the Priapus Toxin® that’s going in the corpus cavernosum, is affecting the blood flow in the corpus and possibly the autonomic nervous system. So subdermally… You’re not doing it, are you, Bill?

Hung William Song, MD:

We do the P-Shot® just like the way you teach it.

Charles Runels, MD:

Botulinum toxin with PRP and put it in the corpus cavernosum, which would help erections and make the penis larger in the flaccid state. When you mix the PRP with HA to enhance the girth, are you also putting botulinum toxin in that one?

Hung William Song, MD:

No. No.

Charles Runels, MD:

Yeah, that’s what I wanted to be clear about. Yeah, because that wouldn’t really contribute to anything, I don’t think.

Hung William Song, MD:

No, not.

Charles Runels, MD:

So, that was their question. So, to answer your question, PRP goes into the corpus cavernosum, but no HA goes into the corpus cavernosum.

And then, subdermally you would put the PRP with the HA, but not the botulinum toxin.

Right?

Hung William Song, MD:

Yes.

Charles Runels, MD:

Am I in sync with you?

Hung William Song, MD:

Yes.

Charles Runels, MD:

Okay. Then the other one was, which one you do first. I think the main thing here is if you’re going to do shockwave, I think I have no research to back this up, but it just makes sense to me. Because what’s coming out of those platelets are small peptide chains that the shockwave could damage.

I want to know what you think, Bill.

Hung William Song, MD:

Yeah, I’m actually doing the shockwave afterward. And I don’t think that it’s going to damage the peptides or anything like that.

Charles Runels, MD:

Okay. There you go.

Hung William Song, MD:

It activates the PRP.

Charles Runels, MD:

Okay. All right. There you go.

So, let’s see if there’s another question here. I think that might be everything. Okay.

Well, let me give you all one more little trick that will take 30 seconds. And I’ll put these other papers.

I never hear Dr. Song speak that I don’t learn amazing things and get motivated. What amazing pictures you’ve got there.

That can be life-changing for somebody.

Hung William Song, MD:

Thank you.

Free Software to Calculate Female Sexual Function Index (FSFI)

Charles Runels, MD:

I had some software written, and tuned it up. Just wanted to show you guys. It took a couple of months. But if you’ve been on the Journal Club every week, you know that I think the female sexual function index is very helpful, better than the female sexual distress scale.

However, the FSFI is a pain to administer and grade. So, I had someone write some software. I put it where you could just get to it.

You don’t even need your password.

And my thinking was that you could hand your iPhone to someone, or you could text a link to your patient. They take this FSFI, and then the software grades it and it’s all the different domains: lubrication, orgasm, desire, pain, and satisfaction. So, you have all those domains, and they could literally do it in a few minutes in your office or do it in a few minutes and take a screenshot of it and send it to you.

But it had some bugs in it. So, I want to show you where it’s living now, and you guys can use it.

I know we do SHIM scores on men all the time, but I don’t see people doing FSFI except in a research situation. I don’t see people using the scoring system as much in women. And I think, at least in my case, that was a big reason why: I just didn’t want to grade papers when I got home. It was too much of a hassle to grade sitting in a busy office.

So anyway, I put it in a different place. It lives at Oshot.info/quiz/fsfi.

You click this (see video) and then it says, start the quiz.

It gives them instruction and defines what sex is because some of them may be like Bill Clinton; they may not know what sex is.

So, it tells them what sex is and what arousal is, and then you answer the question.

They click it, it gives them the next question.

Normally, if you’ve ever tried to grade the female sexual function index, the different questions for different domains. But then they’re graded differently, and you have to multiply them by a factor that takes some time. And like I said, the information you gather is amazing.

Thank you for being on the call, Bill. Always appreciate you.

Hung William Song, MD:

Thank you so much.

Charles Runels, MD:

Yes, sir. If you’re going to do this (penile enhancement using the P-Shot® combined with an HA), contact Dr. Song. I haven’t found anybody else who does it or teaches it better. Have a good night.

Hung William Song, MD:

Good night. Thank you

References

 Cervelli, V., L. Lucarini, D. Spallone, L. Brinci, and B. De Angelis. “Use of Platelet Rich Plasma and Hyaluronic Acid on Exposed Tendons of the Foot and Ankle.” Journal of Wound Care 19, no. 5 (May 2010): 186–90. https://doi.org/10.12968/jowc.2010.19.5.48045.

Eisa, Eslam F. M., Shimaa A. M. Ezzeldein, Haiam A. Mohammed, Asmaa A. Abdallah, Wael A. M. Ghonimi, and Mustafa Abd El Raouf. “Comparison of the Therapeutic Effect of Platelet-Rich Plasma and Injectable Platelet-Rich Fibrin on Testicular Torsion/Detorsion Injury in Rats.” Scientific Reports 14, no. 1 (August 5, 2024): 18045. https://doi.org/10.1038/s41598-024-67704-4.

Gudelci, Tansu, Yigit Cakiroglu, Aysen Yuceturk, Sevil Batır, Ozge Karaosmanoglu, Zeynep Ece Utkan Korun, Ilter Tufek, Ali Riza Kural, and Bulent Tiras. “The Effect of Intratesticular Autologous Platelet‐rich Plasma Injection on Sperm Retrieval Rates and in Vitro Fertilization Outcomes in Couples with Non‐obstructive Azoospermia.” Journal of Obstetrics and Gynaecology Research, September 20, 2024, jog.16093. https://doi.org/10.1111/jog.16093.

Jeong, Hyeong Guk, Sun Tae Ahn, Jong Wook Kim, Kyung Keun Seo, Dong Soo Lee, Hong Sun Uh, Je Jong Kim, and Du Geon Moon. “Practice Patterns Among Korean Urologists for Glans Penis Augmentation Using Hyaluronic Acid Filler in the Management of Premature Ejaculation.” Sexual Medicine 6, no. 4 (2018). https://doi.org/10.1016/j.esxm.2018.06.005.

Moon, Du Geon, Tae Il Kwak, and Je Jong Kim. “Glans Penis Augmentation Using Hyaluronic Acid Gel as an Injectable Filler.” The World Journal of Men’s Health 33, no. 2 (2015). https://doi.org/10.5534/wjmh.2015.33.2.50.

Seckin, Serin, Hadi Ramadan, Marco Mouanness, Michelle Kohansieh, and Zaher Merhi. “Ovarian Response to Intraovarian Platelet-Rich Plasma (PRP) Administration: Hypotheses and Potential Mechanisms of Action.” Journal of Assisted Reproduction and Genetics, February 17, 2022. https://doi.org/10.1007/s10815-021-02385-w.

Shaeer, Osama. “Shaeer’s Glans Augmentation Technique: A Pilot Study.” Journal of Sexual Medicine 9, no. 12 (2012). https://doi.org/10.1111/j.1743-6109.2012.02966.x.

Turcan, P., P. Pokorny, J. Kvintova, and M. Prochazka. “P-02-23 Glans Penis Augmentation Using Hyaluronic Acid Gel for the Treatment of Premature Ejaculation.” The Journal of Sexual Medicine 17, no. 6 (2020). https://doi.org/10.1016/j.jsxm.2020.04.177.

Tags

PRP, P-Shot®, O-Shot®, cosmetic procedures, fertility, injection, testosterone, testicle, penis enhancement, HA fillers, sperm count, ultrasound, seminiferous tubules, ovaries, ovarian atrophy, sexual health, erectile function, penis augmentation, collagen, tissue regeneration, necrosis, nodules, pigment changes, aesthetic procedures, hyaluronic acid, Sculptra, Bellafill, shockwave therapy, BrandShield, intellectual property protection, cosmetic dermatology, penile enhancement, sexual confidence, PRP therapy, Charles Runels, H. Bill Song

Helpful Links

=> Next Hands-On Workshops with Live Models <=

=> Dr. Runels Botulinum Blastoff Course <=

=> Dr. Song’s Course on Using HA fillers to enhance the girth of the penis <=

=> The Cellular Medicine Association (who we are) <=

=> Apply for Online Training for Multiple PRP Procedures <=

=> FSFI Online Administrator and Calculator <=

=> 5-Notes Expert System for Doctors <=

=> Help with Logging into Membership Websites <=

=> The software I use to send emails: ONTRAPORT (free trial) <= 

=> Sell O-Shot® products: You make 10% with links you place; shipped by the manufacturer), this explains and here’s where to apply <=

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