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
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.
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.
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.
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 (firstname.lastname@example.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.
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.
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.
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,
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.
Cellular Medicine Association
Dr. Marco Pelosi III: Our next speaker is probably best described as the Michael Jordan of platelet rich plasma, Dr. Charles Runels from Alabama, that pioneered the O-Shot® [Orgasm Shot®], the Vampire [Face]lift®, the P-Shot® [Priapus Shot®], and he’s taken all the abuse and he’s given the world some very, very useful procedures for everyone. He’s going to talk about the studies he did and the studies done in platelet rich plasma in regards to sexual function. Dr. Runels, it’s a pleasure to have you here.
Dr. Runels: Thank you for having me.
I’m going to go through a whirlwind look at research that’s been done where people have used PRP to help with sex. Much of the research has been done by the people in our group, and I’ve described many of them in this room who have done this research. It’s a for-profit organization, but we pay for research, we pay for education, we pay for marketing for our providers. Just to echo what you just heard, sex is much more than about just having fun. Rainer Maria Rilke said it’s just so correlated to the creative experience that it’s affecting how we do our work, how you do your presentation, and how – of course – relationships and families.
I want to echo that sentiment, and remind us that back in 1980, if you look in ‘Urology’ – this was ‘Urology’ 1980 – the most common cause for erectile dysfunction was thought to be 85% psychogenic. Here’s a quote from ‘Urology’ where urologists were encouraged to become counselors, because most of erectile dysfunction was thought to be psychogenic. Of course, I’m echoing the penis stuff because if you take a penis and shrink it and unzip it, that becomes a clitoris. I’m thinking most of the research will eventually apply to that. Certainly, our attitude is applying because we’re back in the … We’re not, I’m preaching to the choir, but many of our colleagues are back in the 1980’s and saying the main thing we have for sexuality for women is counseling.
My thinking that perhaps, as you guys do, some of the pathology that applies to the penis may apply to the clitoris, and maybe some of these women are suffering from actual genital histopathology, not just psychogenic problems. We have this one FDA approved drug now for female sexual dysfunction that’s a psych drug, flibanserin. It’s a useful drug, but obviously, we need much more and maybe we should think in terms of systems, like we do for the rest of the body.
Platelet Rich Plasma.
Obviously, this is not a new idea. This is from, this month, over 9,000 papers indexed in PubMed about platelet rich plasma. Our orthopedic colleagues, our dentist, our facial plastic surgeons have worked with this, and all we have to do is take their ideas and then hopefully people in this room will extend what I’m about to show you and just take those ideas and adapt them to the genital space. Here’s some of the growth factors we know about. There are many more. They have these effects. These are good things for the genitalia. Down-regulating autoimmune response, proliferation of fibroblasts, new angiogenesis, the adipocytes enlarge and multiply – think labia majora, collagen production, neurogenesis and maybe some glandular function.
There’s never, in all those 9,000 papers, I still cannot find one serious side effect. No granulomas, no serious infection. PRP is what your body makes to heal when you do your surgeries and help prevent infection. Obviously, there are always certain things that can happen, bruising and such, but if you have a serious life-threatening complication from PRP, you will have the first recorded in all of that 9,000 plus papers. That’s a nice thing.
We have commercially available methods for preparing it, within 5 or 10 minutes of the bedside, and the devices are FDA approved. So you guys don’t get confused, obviously the FDA does not approve your procedures. That’s a doctor business. They don’t approve blood that belongs to you, just like your spit and your saliva and your skin. They tried, at one time, to control eggs and the gynecologists said, “Hell no.” So they don’t control eggs and they don’t control blood, but you should use an FDA approved device if you do this [approved for preparation of PRP to go back into the body].
Here’s some of the ideas about down-regulating autoimmune response. We have split-scalp studies showing that PRP helps alopecia areata better than triamcinolone. More hair growth that comes in thicker. Here’s rat studies looking at rheumatoid arthritis. What do we have in the genital space? We have lichens sclerosus. We did some before and after pictures where you use stem cells mixed with PRP, and before and after pictures show improvement. Of course, that’s two variables because you have stem cells and you have the PRP.
We took the same idea and just used PRP. Andrew Goldstein worked with me on this, and we had two blinded dermatopathologists. The protocol was biopsy, PRP, wait six weeks later, another PRP injection, and then six weeks after that, another biopsy. Two blinded dermatopathologists out of George Washington University did not know the before or the after. We showed statistical improvement in both the histology and symptomatology. Here’s our histology. You can see obviously, that’s the same magnification and we’re showing decreased hyperkeratosis. That’s obviously healthier tissue. A layperson could tell that’s better. Of course if you look at the gross pictures, lady on the left as you guys know, she has pain wearing her blue jeans. The lady on the right is back to making love to her husband. They’ve invited me into their close Facebook groups and I saw a post a few months ago. Quote says, “I was sitting next to my husband, whom I love, last night. I was afraid to hold his hand because I was afraid he would become aroused and I’m bleeding and hurting today.” That’s what you guys are helping.
We published that in ‘Lower Genital Tract Disease’. We extended it because it worked. We published this past January in the journal of the American Academy of Dermatology. You have some science to go do this now.
One of our providers, Kathleen Posey, who’s a gynecologist out of New Orleans, took this idea and then she said, “Let’s do some dissection in the office”, and she presented this in Argentina, published it in the same journal ‘Lower Genital Tract Disease’. Here’s one of her patients, where you can introduce [inaudible 00:06:44]. It had been 12 years since she had had sexual intercourse, penis and vagina intercourse, with her loving husband … 12 years. She was being followed by a dermatologist on high dose clobetasol. Kathleen dissected it out in the office and then injected PRP … 8 weeks later, she’s having comfortable sex with her husband. She’s now 3 years out. She’s had to be treated with PRP, not repeat surgery … PRP now, 2 other times a year apart to maintain that result. She now has a series of 60 or so patients that she’s now going to publish with similar results, where she’s dissecting out – as you guys know how to do – treating the [inaudible 00:07:27], but then following that with PRP injections to help the healing and decease the autoimmune response.
That same doctor, Casabona, repeated his study with lichen sclerosus in men [BXO], and showed with just PRP alone … This study of 45 men with repeat treatments … It is cumulative, 2 to 10 treatments, the same thing. All of them stopped their steroids. None of them started back. Only one went on to have circumcision.
Peyronie’s disease, another autoimmune disease … This came out this month out of Wake Forest, where they took men and they followed their results with Peyronie’s disease. Not only did their Peyronie’s improve statistically, but they also improved their erectile dysfunction by 5 on that scale of 5 to 25 that the urologists use. For some reason, thankfully, they threw in one woman just for good measure, and showed that it helped her incontinence. They just tucked that in as an aftermath.
Ronald Virag, as you guys know as the legendary vascular surgeon who was first to present the idea of intracavernosal injections for erectile dysfunction, out of Paris. His big thing now is PRP for Peyronie’s. He just published a study where he showed that this is comparing PRP with Xiapex, which is a $50,000 series of injections, FDA approved version of collagenase. He showed that PRP works better with few side effects. There’s a risk of about 1 in 30, that actually go from a bent pencil to a fractured pencil and a limp noodle. You don’t see that with PRP. You see the side effect is the erectile function improves. He showed the same thing, actually, in his studies that erectile dysfunction improves by an average of about 7 on that 5 to 25 point scale.
Wound Healing/Scar Resolution
Let’s think about the [inaudible 00:09:29] literature. Look at this, there’s so much of this out there. This is looking at post-operative adhesions, lots of studies looking at scarring with microneedling and PRP. This is a split-face study comparing PRP with microneedling verus PRP … Excuse me, microneedling with saline or Vitamin C serum and split-faced studies in PRP wins. Dr. Sclafani did some studies in the cosmetic space looking at increased collagen production and fibroblast activity, and never a neoplasia documented. People worry about that. This is not indiscriminate blindness blind growth. You don’t worry about carcinogenesis when you do surgery and it’s the same PRP that’s causing healing. There’s actually some helpful immune processes that go on, that you could argue actually might help prevent cancer. I’m not going to make that argument but it might need to be made one day.
If you look further, here’s a wound healing study looking at reepithelialized exposed bone and tendon of the foot and ankle. When I took that and applied, this is a hypertrophic scar that was a year old from cortisone, and then using PRP and Juvederm or HA filler, this is a few days later, a month later, and that’s a year later. Now, take that and think, “How could I use that in the genitourinary space?” Doing that anecdotally, we have many of the members of our group are seeing help with episiotomy scars or dyspareunia, pelvic foreplay instead of injecting that pelvic floor tenderness with triamcinolone. Physiatrist for the past ten years has been using PRP, your sports medicine doctors. Now, when you palpate it, consider injecting with PRP instead. Dyspareunia from mesh and that unknown dyspareunia, we’re seeing this is where we need you guys to help extend the research. The science is there that it should help and it seems to be helping. Not 100%, but about 80% in people with dyspareunia.
Here is a look at a gentleman who did … He took the mesh out and then he patched the hole with a gel form of PRP and showed benefit. We’re finding anecdotally – no one’s done this study yet, here’s another one for you to pick up … I’m giving you low hanging fruit. We’re seeing anecdotally that if you inject in the distribution of the pudendal nerve, which seems to be inflamed in some women with mesh pain, that their pain will frequently go from 9 out of 10 down to 1 or 2 out of 10, without even taking the mesh out. Just another place where we need some research done.
Here, we have rat studies looking at inflammation. Let’s think about this one. Here’s a rat study where they modeled cystitis and we are seeing in chronic interstitial cystitis without even infiltrating the bladder, just infiltrating in the periurethral space, some of our women are getting better. I’ve had two separate urologists call me and say, “Charles, I can’t believe it. I was doing this and expecting not this to happen. I have these patients now who have had chronic interstitial cystitis pain for years, and it’s gone.” Not 1005 but finding out who’s going to respond and who’s not and why, there’s a lot of variables that need to be thought about that you guys will hopefully do the research.
Here’s a study that came out in the ‘Journal of Sexual Medicine’, where a guy took … the [inaudible 00:12:51] men who have an erection of 3 inches or less and then he treated them with PRP, combined with a pump, and showed that if you repeated it every time you did it, it grew by about 7 millimeters. I’ve always thought if I could give you a guarantee half an inch to an inch with anything, I’d get my picture on a postage stamp. I don’t have that yet, but I can tell you that we’re seeing about 60% of the time we do this procedure, men will see some sort of growth.
If you look at the neovascular space, there was a study out of Southern California that was published in the ‘Journal of Sexual Medicine’ where they transferred adipocyte stem cells to the penis of diabetic rats. They showed new endothelial cell growth and increased nitric oxide activity in the dorsal nerve. Would that be helpful in the clitoris? Probably, but the interesting thing is the adipocyte-derived stem cells were attacked and they died. The postulate was the improvement was from the growth factors.
Penile Rehabilitation and Erectile Dysfunction
I have seen what [inaudible 00:13:52] have seen in that when you inject this in the penis, erectile function goes up on the average of about 5 to 7 per injection. Think about nerve repair. We have rat studies modeling prostrate surgery, showing that the nerves improved with PRP and so we have, again, another clear place where we need studies if you add this now to the usual protocol for rehabilitating the penis post-prostate surgery … would you see benefit? We have seen that in some of our patients who are a year or two out who failed the rehabilitation part of that. Would that help your patients who have, say, numbness and decreased function from riding their bikes too much, or trauma? I don’t know, but it’s worth thinking about and publishing research about.
In thinking about where to put this, where we do our O-Shot, when we do PRP to the anterior vaginal wall, we’re putting it as distal from the bladder as possible. We found that it works better. We’re essentially making a liquid sling. Think infiltrating and getting ready to put in the mesh. That’s what we’re doing. Very simple, only we’re using a material that has never caused a granuloma ever. Doing that, frequently our patients will have their incontinence go away that day from the actual liquid and as it’s replaced with new tissue, it never recurs. Usually, you’ll have to repeat the procedure at a year or two out depending on the etiology. Sometimes it lasts longer.
The interesting idea is what might be happening with those [inaudible 00:15:21]. They become more active, and does that help with sexual function? The other place we put it is in the actual corpus cavernosum of the clitoris. We use [inaudible 00:15:29] ultrasound visualization and see it flow down into the body of the clitoris by the pubic ramus and the wave form goes to what you see in a flaccid penis to what you see in an erect penis.
Improved Orgasm & Libido in Women
That’s my time, almost done. Just 30 more seconds. Here’s a pilot study we did where we showed that in women with female sexual distress, that it dropped by an average of 10 and female sexual function went up by 5 when you do what I just showed you. Here’s a study that Dr. Neto, who may be here, published where he looked at incontinence and sexual function down in Brazil and showed that 94% of the people loved it. The question here is how would you combine it with your energy source? It works great in the face if you do laser and follow it with PRP … better results, faster healing. Is it going to … We need people to help us work out the algorithms. Not everybody has laxity, but when you have something, when do you use which treatment and when do you combine it with PRP? We need those answers, because I don’t have them yet. This is possible helps.
I am done. Thank you very much for having me. I put all these references at that website, if you want to go download them. Thank you. You guys have a wonderful conference.
Dr. Marco Pelosi III: Thank you Charles. Beautiful
Charles Runels: I thought it may be helpful to start offering suggestions about what I’m reading, and what others in the group are reading and writing, so that our weekly meetings become not just sharing our procedures but approach being something like a journal club or a reading club, book club. That’s why you see what’s here on the screen now. I just got this in the mail. I bought it before it was published. It just came today, so I’m extremely pleased with this. The reason I’m so interested in centrofacial rejuvenation is something if you know, if you’ve attended my class. That is the most important part to improving … It’s the number one place to improve the appearance of going back in time in appearing younger. It’s the eye to the mid-cheek.
Some of the procedures in here are surgical. Chapter eight has some beautiful diagrams offering midface volumization with fillers. It talks about the anatomy, and highly recommend this book. I’m putting a link to it in the chat box, and I’ll put a link to it on the page where I put the recording, but very well done. Other chapters are helpful in [inaudible 00:01:53] videos. Part of what brought this up is I had a question today. I had some cosmetic questions. Let me pull those up. Then I’ll field questions from you guys. I copied this out of a email that came to me. Number one, “Why use none activated platelet-rich plasma on the face? Can we use activated prp and when?” Again I’m going to put it here and recommend that you guys check it out. This question, I’ll cover it again because it’s helpful.
Finding the Answer to Questions
If you go to Cellular Medicine, actually I want to just show you where a lot of these questions live. I’m happy to go over it, but if you have a way to search and find it very quickly without waiting for me to answer, then that would be a better thing. Some of you guys don’t know how easy it is. If you go to CellularMedicineAssociation.org, and you just put in the search box right here, so you can say activation. Hopefully, I’ve got that in there somewhere. There you go, so it’s like an index. I don’t have something that says index but it will pull up … Because I’m having all these transcribed, it will pull up any transcription that has that word in there, and so that’s a good way to search for things.
You could also go to the membership sites, so if you went to VampireFacelift.com into the member section, and this is the backside so you wouldn’t see this. You would land on, I’ll show you. You would land on the dashboard, so it would look like this right here. Then see where it says, “Post,” you could just click and you post. There should be a search box. I guess there’s not. I need to put one on this one. Most of the membership sites have the search box, so my bad. I’ll put one there. You could also go through here and look at just there’s the titles, recent comments, and there’s key words. This one needs a search box. Anyway, that’s the two places to look on our main website, the Cellular Medicine Association.
Looking at recent posts, and you’ll get the most recent stuff, but on the membership sites, the other place to look, it’s just look under the directory. I mean go to the dashboard, and then look under webinars. There’s the dashboard. No, not taking you back. Anyway, that first dashboard where we were at, it’s a directory, workshops, forums, and then there’s a page for webinars. Then at the bottom of every page there’s a question and answer session. You can see there’s a place to post it, so go in there. The good thing about doing that is you get answers from other people, not just from me if you do that. There’s one about calcium chloride. “Does it help? When do I use it?” Then you can see well, here’s the answer and it takes you to a recording from one of our webinars.
Activation or Not Activation of PRP?
I like doing it that way because it makes sure, it give everybody a chance to contribute, so it quits being about Charles. I’ve been fortunate enough to play around with plasma for eight or nine years, but newer people in our group are also doing that and have different expertise so it’s helpful. Here’s the answer to the question of why use nonactivated platelet-rich plasma. The reason for not activating it is the calcium makes it hurt more. Calcium chloride just hurts. The other reason to not use it as in activate the plasma is that you do get around 65% activation without activating it because when you put the plasma, inject it into the tissue, the exposure of the platelets to the collagen of the tissue itself activates it as it would in a normal [inaudible 00:06:47] if you had an injury and the platelets come outside the body, it activates the [Thorman 00:06:51] cascade, exactly the same thing.
You get 65% activation if you just take the inactive platelets in the syringe and inject it subdermally or intramally, and it doesn’t hurt as much. It seems to work well enough for the hair and the face. Most people are not activating. The reason we changed that and activate with the [Priapus 00:07:16] Shot, and with the O-Shot, and with when we’re trying to regrow nerve as with decreased sensation in the areola of the nipple, is because we’re thinking that because it’s more therapeutic type effect, and because we’re trying to maintain the material in a smaller space. Geographically we want it to stay close to the urethro so in a very small area the calcium makes it activate more quickly and more thoroughly. That’s the reason. No one can fault you for activating it with the face as well. It’s just a cop out to make it not hurt as much.
Can you “use prp in the vaginal lining?”
Number two, “Can you use prp in the vaginal lining?” I have used it everywhere, and I see one of our gynecologists is on the call, so I may get Kathleen Posey to comment on this too. Can you use prp in the vaginal lining? You can pretty much use it everywhere as best I can tell. I can’t find any ill effects except in one case where it was injected into the eyeball trying to do something with the retina, so don’t give anybody a shot in the eyeball. Otherwise, I have injected circumferentially. I’ve injected in the labia minora, the labia majora, posteriorly. Anecdotally, we’ve had two people in our group see help with rectal incontinence in a severe postpartum tear. That was years out and still saw some improvement in rectal incontinence. We’re using it all over.
The only reason I quit putting it completely around the vagina circumferentially is that in the beginning it was so costly I was trying to avoid injecting more places than needed because it cost us so much to make the plasma. I found, so 80/20 rule, I could get actually all the results I needed by just injecting around the clitoris and along the anterior vaginal wall thinking that’s where a lot of the sensation is as in Grafenberg, not just the spot but the whole urethra being sensitive, the Skene’s glands, that’s where a lot of the sensation takes place. It’s also up there near the inner part of the clitoris and all the nerves [inaudible 00:09:45], just a lot of magic happens there.
Not so much the anterior vaginal wall, there’s not that much lining there. I mean, excuse me, there’s not that much sensation there. Having said that, I’m going to see what Dr. Posey has to add to that. Then we’ll get back to the face, the best way to treat nasolabial …
Charles R.: … that and then we’ll get back to the face, the best way to treat nasolabial folds. So if you don’t mind, I’m going to unmute you, Kathleen, and see because I know you’ve done a lot of these. Are you able to talk, Kathleen? Are you there? You may not have a-
Kathleen P.: Yes. Hi. Hi.
Charles R.: Good to hear from you.
Kathleen P.: Hi. You too. I have injected it there not a lot [inaudible 00:10:26] end up with some left over, I’ll inject it in the labia minora, the labia majora. And it just depends, if they’re having pain in that area, I’ve definitely used it a fair amount and it does help decrease the pain.
Charles R.: In the lateral vaginal wall, you mean?
Kathleen P.: I have a little-
Charles R.: He didn’t really say vaginal. He just says vaginal lining, doesn’t he? I’m sorry. Go ahead.
Kathleen P.: Yes some … Yeah. I’m more doing it in the posterior vagina. I don’t know if it hurts sticking it in lateral because the vessels and stuff. I worry about hematoma. I wouldn’t go too deep if I were to inject it there.
Where to go to create an “interview video” for your website
Charles R.: Okay. You know what? While it’s on my mind, if you will do this, Kathleen. And I’m going to put it here so others may want to. If you go … so far I’ve only done this with three, excuse me, two of our providers, but I’ve never made it public. I’m trying to make it … I’ll show you what I’m doing. If you go to the O-Shot® website and you on the … over here on the recent posts, you can see I’ve talked to Dr. Goodman about some of his surgical techniques and how he thinks about orgasm and how the different procedures he’s using and I’ve just recorded it and put it there for patients and doctors to learn from. There’s nothing … becomes a very good explanation of the surgeries for potential patients as well.
So back to … oh, you can’t see it. [inaudible 00:12:04] where you can see what I’m talking about. There. So this is a post on the O-Shot® website and it just comes in recent posts and I’ve done that … I’ve set it up to do with [inaudible 00:12:21] and we had some … we weren’t able to record it well and I’ve done it with another one of our providers, but I’m going to put here … it’s so hard. Everybody’s schedule is so busy, but any physician who has … who wants to be interviewed, I see it as a great way to … cellular … let’s see … it’s a great way to get the word out about what we’re able to do and, just as importantly, what we cannot do and how we’re thinking about the science. And here’s where to set that up…
So I’ll show you what happens when you set that up and where to go. So if you take that and put it into … and I’m hoping you’ll set this up, Kathleen, so I can interview you because you got so … I’ll pick your brain a little bit at a time when we do these webinars, but you got so much information about lichen and the other stuff.
Okay so if I put that in there, it takes you here and then if you go to 30 minute phone meeting, book that, and we may actually be on the phone longer than that but just … and you can see you can just click that and pick a day and that fits your schedule and then I’ll record it. You don’t have to have PowerPoint slides. You can if you want, but any doctor in our group who feels like they have a message they want to deliver that would be helpful to doctors and/or patients. I like the interview format because it gives me a way to showcase our physicians and, because I’m seeing a lot of the questions that come by email and such, it gives me a way to get a more balanced answer to these questions rather than me doing all the talking, which is just not the way it should be. Okay, let me get back to these questions. So if … I’m going to put that in the chat box too and, hopefully, you’ll set that up, Kathleen. So anybody else can call because you got so much … how many years have you been doing this now? Three? Four?
Kathleen P.: About four.
Charles R.: I know no one … I don’t know anyone who’s inject … who’s treated more people with lichen sclerosus [using the O-Shot®] and you’ve got a strong surgical background too, as strong as it comes so let’s set that up. I’m overdue to do that. Okay, so back on topic. I’m just going to leave your mic unmuted there, Kathleen, and get back to finishing these questions. Let’s see. Go back to here.
What’s the best way to treat nasolabial folds–PRP, fillers, or threads?
Okay. So now for a face question. What’s the best way to treat nasolabial folds? With therapy or threading or with filler? I think this one is … let me pull up a picture. Let’s see if I … I think a picture would answer it better. Let me find a picture I have permission to use. Because this is definitely a case a picture’s worth way more than me babbling on and on.
Okay, here. So if this is the problem that you’re trying to make go away, the question was: is it better to use fillers or plasma or some sort of thread lift or surgery? There’s lots of different things. What can you do for that? So the main principal I follow is that this cheek area is more important than whether there’s a line present here or not. You’ll see nasolabial folds in children, but this is not necessarily an age line. It become a sign of age, when relative to the rest of the face, when you see that this … let’s see if I can draw on this. Let’s see what I can draw. Good. Okay. So when there’s a stripe, there’s a heavy strip, you can see it kind of goes like that there, with this being flat over here. And when you see that, it’s not the line that’s making people look older and you can kind of see the appreciation of a line right there, but not so much visible there sort of like a dash line. There’s definitely a line there under the eyes and then there’s this line and then this looks relatively flat. When you see that, that’s a person for whom either fillers or platelet-rich plasma is going to help.
If I’m trying to decide which will be appropriate, then I go by how much volume loss is there. If there’s quite a bit of volume loss here, the chances that I will maintain … the shape will look beautiful if I just fill it up with plasma, but the chances that I can maintain that shape become less good than if there’s a lot of volume loss here. If it’s someone who’s never had anything done and they’re … if you’re looking for numbers, if they’ve never had anything done and they’re 40 and up, then they’re probably going to need some fillers there, especially if they have a thin face. If they’ve got a full face and they’re younger or even if they’re over 40 or 50 and they have a full face, sometimes you can get by with the plasma alone. But the bottom line is that adding volume here is going to pull this up and round it out so there’s not a heavy stripe here. And then even if you have a line here, it’s going to be less distracting and not really age causing.
And so that’s kind of how I judge it. So I either use plasma plus prp if they can afford it and they have a fair amount of volume loss or if they’re … if I use prp alone, it’s usually in someone where the volume’s pretty close to where it needs to be and they kind of just want to be fluffed up and usually that’s … they’re 35 or under or they’ve had some work done already or their face is already full just because of their body weight. So most of the time, I’m using both. As far as the threads go, if you do the threads, I would still consider doing this because now you’re doing something similar to a surgical “facelift” but relative to the bone, even though you’re pulling this fold out, you’re pulling the tissue close.
Charles Runels: Even though you’re pulling this fold out, you’re pulling the tissue closer to the bone. You’re really collapsing the face relative to the bone and though the line looks better, you have some risk of causing skeletization and not that round, full feeling look that’s in a younger face.
In the end, all three, the answer to that question is, they all three work. That’s the way I decide. I would seldom use a thread without using fillers or most of the facial plastic surgeons now, almost all of them, even if they do a surgery and pull the skin back, they’ll do it in culmination with fillers to maintain the shape so you’re not just chasing a line. You’re creating a younger shape. I think that answers that question.
I think there’s another one here. Anybody want to add to that, just click the button and I’ll unmute your mic for you. Let’s see. Let’s get back to that question. I think I answered it, just to be sure I did all that. Yeah. That answers that question.
There’s one in here that some of our callers. That’s a good question. Why do you not have a dashboard similar to the others with supplies and videos with a facelift like the other procedures? It’s just simply because I’m the one that’s doing it. I apologize. I just haven’t done it yet.
What they’re referring to is if you’re on the facelift, the dashboard is not as organized with O-shot and P-shot. It’s all still there, but you just have to look around for it more. I’m actually trying to recruit someone who can help me with the websites. I’m still doing them all myself. I started doing websites in 1998 and I can’t find …
So far, I haven’t found anyone that suits me. They’re either over-qualified because they’re actually writing code, which is what I need or they’re under-qualified and they can’t write it. If anybody knows a good web design person that wants to move to Fairhope, then send them this way.
Treating Bell’s Palsy with the Vampire Facelift®
Let’s see. Any other questions? There was one that popped up on the Vampire website from Dana. Let me pull that one up because I answered it. Here it is. I went ahead and answered it, but let’s cover it here because it was a good question.
Dana says she had a beautiful 56-year-old patient who had general aesthetic questions. This is really important because I’ve never covered this in a webinar, by the way, so I’m so grateful for this question. She said, “She’s not new to injectables, but has not received any kind of treatment for the last six months because she has left-sided Bell’s Palsy.”
“Previous management for her palsy’s included prednisone, anti-virals, acupuncture. Her friends think she’s showing improvement. Although this wasn’t the reason for seeing me, I’m wondering if PRP might help with the Bell’s Palsy. When you search on ClubMed, it appears not only to be safe, but possibly helpful.”
Yes, is the answer to that. I haven’t counted, but I know at least two people, maybe three, that have told me that dramatic improvements. As you know, Bell’s Palsy can come-and-go, so maybe it was just luck of the draw treating a lot of diseases that wax-and-wane, who knows?
I think the logic is there when we have something that’s an anti-inflammatory and is an immune enhancing-type therapy. It makes sense that it might help Bell’s Palsy. Also, it’s a nerve re-generator. The last time I looked, it was about 60 or 70 papers about that. This is an important thing that I’ve never talked about so thank you for that question.
I would get a really good consent form because obviously if you’re not treating Bell’s Palsy, if you just gave her a Tootsie roll, it could get better or worse and has nothing to do with your Tootsie roll. In the same way, there’s always a chance it may worsen even though the science indicates it should get better.
I’d get a good consent form, which we have on the websites now that we’ve even enhanced our consent forms. If you haven’t downloaded them lately, download one. We’ve also made an Amnion version. There’s a Vampire facelift and there’s a facelift with Amnion. There’s an O-shot and O-shot with Amnion for those of you who are considering adding that to your procedure.
If I were giving her the Rolls Royce treatment, I would consider an injection. Do the Vampire facelift and add some Amnion to it. She’d have the best we know how to do.
Should you stop anti-coagulants before doing the P-Shot® or the O-Shot®?
Let’s see if there’s any other. Here’s another question. Any reason to stop anti [inaudible 00:25:46] prior to P-Shot® or O-Shot®? Here, I’d treat this like an injection, not like a surgery. Most people who are on anti-coagulants are on them for serious reasons.
I had an internist mentor who always said, “The most dangerous medicine an internist ever prescribes is Coumadin.” You can make the case with just a baby aspirin itself. The last time I looked, something like 35,000 people per year bleed to death from gastric hemorrhages from aspirin.
They’re dangerous drugs. People are not going to be on them for frivolous reasons. Therefore, I usually just don’t even get into it. I just hold pressure longer. Tell them they have more bruising. The bruising is also PRP. It could enhance the effects. We’re just going to hold pressure and I do all procedures as I normally would.
The only thing with aspirin, if it’s possible for you to stop. I know that’s not the question, it’s anti-coagulants, but if it’s possible to stop aspirin or non-steroidal a week or two before, that’s better because it’s going to interfere with your platelet function.
Platelets have a longer half life than a week, so I wonder sometimes about that time frame, but that seems to be the standard recommendation is to stop for a week before and to stop steroids, if you can. I do the procedures and I hold pressure.
I was going to, if there’s not any other questions. Let’s see.
Kathleen Posey: Actually, Charles, I have a question.
Charles Runels: Go for it.
Kathleen Posey: I wanted to say, I did do one Bell’s Palsy patient. She had tremendous improvement, even after a year. But, my question has to do with …
Charles Runels: Wait a sec. You got beeped out for some reason on the sound. You said she had tremendous improvement and then what came after that?
Kathleen Posey: Even after a year. She had the Bell's Palsy for a year and still had some residual left. It was able to take away the residual palsy, which to me, was amazing.
Charles Runels: Beautiful. I’m glad that Dana asked that question. Thanks for throwing that in. Go ahead. You had a question too?
Treating Interstitial Cystitis with the O-Shot® Procedure
Kathleen Posey: I have a question about interstitial cystitis. What’s been the group’s treatment plan on that and how successful do you think that is? I mean, I’ve done a few, but I’m running about 50/50. I was just wondering. I mean, just do a regular O-shot? I mean, that’s what I’ve been doing.
Then, also, the same patient had an urethral caruncle. I put PRP in there. I actually think it grew, but anyway. I told her to go ahead and have it surgically removed, which the urologist was refusing to do but the pain was so related to that caruncle. I just think it needs to come out. Just wanted to know if you knew anybody else that had experience on the line with UC?
Charles Runels: I think what I’ll do. I’ll tell you what I’ve heard, but I think what I will do after this call, is I, as usual, I will send out an email to let people know the recording is there. I’ll ask for more comments from our urologists and gynecologists who are treating UC.
To tell you what I’m hearing is, I’ve had now three separate … Well, two urologists and one uro-gynecologist call me excitedly to tell me about multiple patients in all three practices, not just one, but multiple patients, who became completely well after many years of suffering with pain.
That doesn’t mean, of course, that everyone they’re treating is getting well. I don’t think the placebo effect on someone who’s tried everything under the sun and can’t get better and finally they get well with your one thing. My guess about it is that it’s multi-factorial and what’s working with us, is those that have …
Charles Runels: … the factorial and what’s working with us is those who have some sort of chronic inflammatory/infectious process going on with the Skene’s glands but I’m completely guessing with that. The others may have something that has to do with the bladder itself that we’re not reaching with our procedure. How we dissect out the subset that responds versus that don’t I don’t know but I keep offering to finance a study and if you want to do that and try to … Let’s try to work up a protocol and get it approved, someone in our group needs to do that study. I’d like it to come from a gynecologist or urogynecologist, which I’m not, so that it’s paid more attention to. To help you with it, I’ll post it and try to drum up more interest and let’s talk to each other about it so I appreciate you bringing that up.
Let’s see what else we got. I think that’s all the questions.
How to Get on Your Local TV News
I always like to do a little marketing tip or two. We’ve had a few people lately … Let’s see, I’m not sure what you guys were looking at, let me get you back looking at the web page. Just one minute. We’ve had people on the news, quite a few lately actually, and along with that one was on a radio show. It’s not always TV news, one was on a radio show yesterday and so two really nice luncheons lately. I thought I would pull them out and tell you guys both how to make this happen in your own town and the advice I give people when they call me and say, “Okay, give me tips about what to say on the news.” Then if you just know it’s here the next time I’m still always happy to talk with you. If you know it’s here the next time you get that call you can go refer to this.
I’ll fix it where you can see what I’m looking at. Here’s one of our doctors, she’s a gynecologist, Dr. Singer, and she’s doing the O-Shot and you can see she’s come out of sometimes with the laser treatment. Now, first I’ll start with how you get on the news itself and maybe I’ll just tie it kind of step-by-step what to do. First I would get the name of the person, just your local news channel. You want to call the news and say, “I’m a local physician and I just want to be available for comments or help any time you’re doing a health story that involves whatever you do.” For Kathleen it would be women’s health. If you’re an anti-aging doctor you could say anything that has to do with aging in men and women, whatever you want to be known for.
Then you say, “May I speak with your health reporter?” Here’s the thing. You would think, well they would laugh at you and say we’re too busy. The truth is it’s very, very hard to come up with news and I can prove it to you. Just watch the news and see how many times one news reporter is interviewing another news reporter, it’s very often. How does that make news if they’re interviewing each other? They are really hard up. How many times do you see one … They call it breaking the story. One news channels breaks a story and then all of them talk about it for the next week. It’s hard to come up with something new and interesting every day. Then when they do a lot of times they need an expert to comment. If they have someone on speed dial, and this is what you tell them.
Get to Know your Local Health Reporter
First you ask to speak to this person and you say you want to make yourself available if she ever has a story and needs a comment on or off the record. You tell her or him that you always answer the phone and then you give them your cell phone number and you tell your staff, “If you ever get a call from this news you want to be told immediately.” They are not to take a message, they are to get you to the phone immediately because if you don’t take the call they’re usually on a really tight schedule and they will call someone else and you’ll miss the chance for … I literally have millions of dollars of free publicity just because. They’ll tell me, “You know, I was going to call so and so.” I just ask them and they’ll say, “Yeah, I was going … My deadline, I’ve got an hour to get this done and if I hadn’t answered I would have just been out of the story.”
Tell Your Staff to be ready
You tell your staff … Make sure they have your short list, you probably have that already. “These are the people you’re to never take a message.” My short list is my children, my parents, my sisters, my attorney, and anything with three letters; the IRS, the FBI, the DEA, anything that has three letters get me to the phone. That includes CBS, ABC, NBC, and any news reporter of any kind, doesn’t matter how big or small, bring me to the phone. Then after you get the news reporter on the phone you just tell them that, make yourself available. Now, if you want to make news, if you want to be on the news for free you try to tie it to the national press and I put … If you go here, I think I’ve got it on here, let’s see.
Tie to National News
If you go to the marketing part of this … Anyway, it’s somewhere on here. There’s a webinar about how to take advantage of the national press and marketing … Let’s see, what is it? Insurance practices, avatar, anyway somewhere on here. You’re right, it’s easier to find the O-Shot but the thing is if they have … Let’s say that the press does a story on some new treatment for incontinence, it could be any treatment. Well, you call them up and you offer to comment on it, on your local station about that treatment. Of course, you’re going to talk about your O-Shot too. I actually changed the Health Department policy in my county after someone had an injury in Atlanta, the swimming pool. They had no Health Department inspection here back in the 90s and I said, “Let’s do a story,” and we did a story about how there was no Health Department inspection. It would not have been a story had there not been a recent death in Atlanta from their dirty swimming pool.
You watch the national news and when something happens nationwide that relates to what you’re doing you call your local channel and you offer to do a story about it. That can include national press about our stuff. When this hit the news recently, this one. This is a local station but we have clearer … When we hit the national press I will send out an email. When the email comes out and says … Let’s see. Back in October we made a Real Magazine Website and plugged in others about the Vampire breast lift. When that happened you could have called your local TV station and say, “Hey, the Vampire breast lift was just on [inaudible 00:37:53] website or Allure,” whichever one you want to mention or both, “And if you want to do a story about that I do that procedure here in our city.” Then they will interview you often because you have a local comment about a national matter so that’s how you get in.
Getting Ready to be on the News
Now when it’s time to talk how do you get ready to actually be on the news? Here’s some quick tips and you’ll know where this is. It also applies if you’re just going to be, say, giving us a talking somewhere, and it helps you plan the talk. Here’s the tips on that and I think I’ll type them out for you. Let me pull this up because it’s simple but it’s really helpful. I’ve been on the news more than I like to think about in different countries, in Serbia and London and New York. Anyway, the bottom line is this is the process I go through before I’m going to be interviewed.
I first think about … I imagine not everybody in TV land, not everyone. I imagine one person that I love and I pretend that person is watching and I forget everybody else. If it has to do with men’s health I imagine my son’s watching. If it has to do with women’s health I imagine my mother or a woman that I love and I pretend like that’s the only person and that person is on the other side of the television. That couch is my language so that I don’t sound salesy, I don’t sound anything except sincere and engaged and eager to communicate what the message is. That gets the frame … That is so important and I’m not just saying this. This isn’t something I’m just talking about, I literally do that every time I’m in front of a camera or a microphone if you’re being interviewed by the radio. I was interviewed on Shade 45, which is, it’s a rapper station.
That’s the only time I’ve ever been interviewed where I was the most conservative person in the room. They were talking to me about orgasm and it was a call in station and so it was pretty interesting. It didn’t matter, I was still imagining not talking to everybody out there, being interviewed by radio stations in South America where they have a translator or in Columbia, Mexico. Every time I just think of one person that I love and it’s the only person that matters. Then how do you, what about the content, what do you have in front of you? I think about the problem that my thing is going to solve and I imagine that person with the problem.
Let’s say I do a talk about the O-Shot, then I’m thinking about incontinence or orgasm or whatever it is that is to be the expected topic. Then, and quit speaking about me trying to be pretty or smart or say all the right things, it just becomes about me trying to communicate to that one person I love on the other side of the camera. I know this is all a mind game but it works and it’s the reason you’re there or you just go home. We’re here to solve problems for people and so, not to try to be pretty, they got movie stars that do a lot better job of that than I do, be funny or entertaining. I’m a physician, I’m there to teach people how to solve health problems so that’s the mind frame you get and I forget about the rest of it.
Then I think, and this one’s key I think. I think of key words and phrases that I think would be helpful. Let’s say that … And I write this down and then look at them before I go on camera. Let’s say if it were O-Shot I might think, I would think of the words O-Shot, I might think of the words relationship, relationships healed. I might say psychological pain, you get the point? I would make a list of all the friend … I would day provider group, that’s protected, be careful about seeing someone outside the group. Two and three word phrases that I would want to try and weave into my conversation and realize, no matter what they ask. Ask me about the weather. You say, “Well, is it hot outside?” I would say, “You know, it’s unusually cool down in Florida today, which is exactly what happens to relationships when sex doesn’t work.”
Ask me what color my car is. It’s black. “You know, that’s exactly the mentality people have. They have a black, depressed mood when they don’t get sexual relationship fulfillments in their marriage.” My point is, no matter what they ask you you can weave these phrases into the conversation if you have them in your head before you go on. Then I always thank the person, usually I’ll thank them up front for … It’s not a long thank you, it’s a … Because people get bored by, “Thank you so much for having me.” Nobody wants to hear that crap. What I would say is, “Thank you for being brave enough to talk about sexuality on your show because many people are afraid of that and we know how important this is for relationships.”
You throw little kudos to the host for being brave enough to talk about uncomfortable things and they always like it obviously because they can’t brag on themselves. Then it sets the tone and they know their viewers are looking up to them with a little more respect because of something you said. That’s kind of my, that’s my … Then oh, last thing is you want to invite them to do something; contact you, you want to make sure you have the website because here’s the other thing, here’s the bad, I’ll show you the bad news. Here’s the bad news. If you don’t do … This will go away in about 24-48 hours unless you post the recording. Anyone [inaudible 00:44:51] her TV show. It was good for a boost, it lasted less than a week.
The doctor show will last less than two days. A good news report, and I’m watching the traffic on a website. A good news channel … Actually, sometimes the doctor show you can’t even see the blip because a lot of people aren’t watching daytime TV but a good, very populated website will last two, three days and then it’s gone away so why be on the news if it only gives you traffic for 2-3 days? Once you have it then you take these videos like this and you post them on your website. You see where it says … Oh, I had a link copy. Anyway, there’s a way to actually embed this onto your website and hopefully Dr. Singer has that.
Now, every time a patient on the website that says, “Oh, this lady is [inaudible 00:45:47] enough to be on the news,” and then they hear her explain it in an engaging way with her news interview and it just sits there and educates patients day after day, year after year. Then, that’s when you get some traction and that’s really when you go on the news. It’s not you get a little grip. If that was all you got, honestly, I don’t know if I’d waste my time. That footprint that stays out there and gets showed by all of us on the website, that goes … Oh, are you all seeing what I’m seeing? This can be shared and embedded so that that sits on her website and that is what keeps owning on educating people.
I think that’s it unless somebody has more questions. I think we’re going to stop it there, see if there’s any other questions. The take home do for this one, for today’s thing is that we’re going to try to drum up some more talk about the chronic interstitial cystitis because we’re at least three years overdue for doing that study. If you want to get on the news, at least let yourself be known, make introductions to the health reporter in your town. Then when something happens nationwide you can call, they already know who you are, he or she does, and they know to call you if they have a need for a comment. Then there’s the book that I recommended if you’re doing faces for, that’s newly published about the mid-face because I really like the way he talks about that.
Let’s see if there’s any other questions. Thank you guys, it’s always an honor to have when you spark people interested in what we’re talking about. I’ll post a recording if that’s helpful. Goodbye.
Cellular Medicine Association
See Transcript Below…
Schedule a Marketing Consult & Orientation “Sure Start”
Platelet Rich Plasma for the Treatment of Scars<–
Research about Platelet Rich Plasma
Platelet Rich Plasma Hair Protocol 1
Platelet Rich Plasma Hair Protocol 2
Platelet Rich Plasma Hair Protocol 3
Cellular Medicine Association
Charles Runels: All right. So we had quite a few interesting questions over the past few weeks so let’s just jump right into it. The first one, Dave Harshfield sent me some guidelines that he keeps up with. He’s the head of an orthopedic groups that does a lot of regenerative medicine and he and others have [inaudible 00:00:22] to me these latest updates that came up by the FDA. So I thought I should show them to you because they should be very reassuring to you about what we do.
So here’s the question. If you haven’t gotten this question [inaudible 00:00:35], you will get it. Like I said, we’re going to cover about the FDA, we will cover a couple of marketing things, and then I’m going to go over a receipt that you can you when you give back to people who may not be happy. Everyone’s not going to love what we do and I have a receipt that makes people happy, it keeps you legally clean that I’ll show you. Then we’ll go over some resource that has to do with Platelet Rich Plasma scaring. Plus a few other questions. So let’s see. There are quite a few of you on the call and hopefully some of you can participate with helping answering some of these questions.
Is the O-Shot® FDA Approved?
But first, let’s talk about the FDA and how to answer this question about “Is the O-Shot FDA approved? Is the Platelet shot FDA approved? Is the Vampire Facelift FDA approved?” So the beginning of the answer to that question is that the FDA does not control your body fluids. Doesn’t control your hair, your [inaudible 00:01:42], your saliva. That belongs to you. Your fingers, your toes. The FDA is the food, drug, and device administration. However, if you [inaudible 00:01:52] enough to the material that it quits being your body and becomes a drug, then the FDA does have jurisdiction and the FDA has jurisdiction over the devices you might use to prepare the blood.
So, the analogy I use and some of you have heard me say this in my classes is that if you have suture material that you’re going to use to suit your surgical wound with, you couldn’t just buy material at the sewing machine store. You’d have to use material that was approved for use in the human body. But once you have that device for suture material in your hand that’s now approved by the FDA for using in the body how the wound is sutured is determined by the surgeon who’s sewing the wound. It’s not the jurisdiction of the FDA. They do not govern medical procedures and they do not govern body parts.
So how the FDA delineated what they will govern is with a phrase called “minimal manipulation.” They just came out with these policies. You see that’s stated for immediate release November the 16th. So just last week, they came out with this and this is important news and it’s, I think should be encouraging news for most of us.
So comprehensive regenerative medicine policy framework. Now this gives a pathway for those of us who do skin cells to move forward. But the thing’s most [inaudible 00:03:32] procedures [inaudible 00:03:34] involve the Platelet Rich Plasma and we want to know what’s the FDA doing about this. Now they put on [inaudible 00:03:45] medicalassociation.org, which is our umbrella organization, and look in the recent post, you’ll see FDA physicians for Platelet Rich Plasma stem cells. So here, I have a video and some papers have already been out for quite a while about the FDA. Some of the research articles are up in [inaudible 00:04:04] journal talking about the difference. But I remember one time, the FDA considered regulating eggs so [inaudible 00:04:14] an egg was [inaudible 00:04:16] to be more than minimal manipulation and thankfully the gynecologist said and [inaudible 00:04:20] specialist said no, that’s not right. You shouldn’t be regulating eggs. So the point I’m making here is there’s a blurry line between what’s minimum manipulation and what isn’t.
Here is where I put a link to the most recent position paper. So when you click on that, you will land on this page and you can read the [inaudible 00:04:41]. But if you slide down to this page and click on this one right in your final guidelines for … Let me make sure I get this right. The same surgery procedure, exception, questions and answers regarding [inaudible 00:04:57], if you click on that, it takes you to this. This is where they talk about Platelet Rich Plasma. If you slide down, the exception I’m talking about is how do you decide what is an exception to the minimal manipulation. What do you have to do to it before it becomes a drug? If you slide down to number 13, they tell here “Platelet Rick Plasma and other blood products are not considered even in the ball game … ” You don’t even have to think about an exception because that’s your blood and so blood products, the FDA should, in my opinion be regulating some things. They should definitely be regulating the devices, in my opinion, that we use.
If you’re going to do something with blood and then put it back into someone’s person, that should be carefully regulated by the FDA. Those who might somehow want to make a homemade version of that without understanding what they’re doing or realize that you can spend a lot of money and have a laboratory that takes it to a higher level that most physicians have. But if just somehow you’re going to modify a laboratory kit and do things with mechanisms that were made to analyze blood and somehow just decide you’re going to do that and use it to put blood back into someone’s body, it’s just not good medicine. But assuming you’re using a FDA approved kit to prepare the Platelet Rich Plasma, here it is in black and white. Okay, the FDA considers that to be blood products and they are all hands off about that. So hopefully that answers that question.
Now a real quick marketing thing that you guys … Some of you’ve done and others have not. I’m going to type it into the chat box. If you go to [inaudible 00:07:03].com/cellmed, this is probably the best marketing tip I can give you. If you click on that link, it takes you here. [inaudible 00:07:17].com/cellmed.
By the way, this is really, I think, nice software that anybody can set up on their own that allows you to schedule your appointments for your office even if they’re paid in advance. It allows you to schedule appointments before you even get paid and will integrate with your personal calendar so that’s your software tip for the day. If you put something on there, it looks on that before it decides if you’re free and you can set up all sorts of rules like if you’re going to be off on Wednesdays at three or whatever. So we can use this software to schedule with the [inaudible 00:07:55].
And right here, [inaudible 00:07:58] orientation, the people who fall out of our group and tell us that they are not seeing the phone calls, without exception, there are people who have not done this free [inaudible 00:08:12] where we spend an hour on the phone with you and your marketing person or your marketing person alone and we will do this as many times as you need to until you’re seeing results. It’s free. It’s part of being in the group.
No extra charge for it. We want to see you successful and we’ll give you a tour of the website. A lot of times, there’s tools on there. It goes marketing tools, pre-written notes and providers just can’t see it all. They get overwhelmed of all the emails I send them and just get confused.
So we have three full time people with business degrees in our office that have all been with me at least a year and they are not just experts at this business but they’re experts at how our providers are doing those and they’re just waiting and eager to help you because they know [inaudible 00:09:12]. We have more money for research, we have more money for supporting you guys, not just [inaudible 00:09:23] with marketing and supposed to help you educate your patient. So we’ll put in a plug for that.
Does PRP Cause Scarring?
Let’s go to some science real quick. So these are the questions that I’ve received a few times in the past week. Some of these comes in waves and this past week, I had a wave of questions about Platelet Rich Plasma causing scaring. I think sometimes things get out there on the internet and [inaudible 00:09:55] something on the blog or something, I don’t know what happens. I would think you would just to go pub med and search for scarring. I’ve done this multiple times over the years just to make sure that I’m not telling people wrong. I just put the link to that in the chat box. But obviously our first rule is “do no harm.” The truth is that we all hurt people and we don’t mean to but I had two people crash their car just driving to my office. People can’t get out the [inaudible 00:10:31] without getting hurt. They sure can’t go to the doctor’s office and the best of physicians hurt … We hurt people sometimes. But we want to as much as possible, of course, round down at night and know that we have not hurt people.
So part of the beauty of Platelet Rich Plasma is [inaudible 00:10:50] and I’ve tried to keep up with this, if you hurt someone with Platelet Rich Plasma, if you do with Rich Plasma, you actually have an incredible case as the first case in medical history as best I can tell. So when it comes to scars, for some reason, occasionally laypeople worry that somehow the Platelet Rich Plasma’s going to cause scarring. This is a general thing to worry about because it causing tissue growth. So you might wonder as a physician even or weaker physician or a specialist, you might wonder will this cause scarring. I think it’s [inaudible 00:11:32] for you to see here and if you can quickly [inaudible 00:11:36] through, this is 50 papers that have been published. You can scan through these papers and what you’ll find is Platelet Rich Plasma treats scarring. You’ll see that it being used to be keloid and split face studies use to treat scarring from acne scars, pox scars, surgical scars. It remodels the [inaudible 00:11:55] to make it become more normal.
To a layperson, you could describe scarring as basically tissue that’s healed together, but it’s healed the way that the tissue no longer has a configuration. All of these studies, this is the first page. I think it’s three pages. So it goes on for three pages worth. All of these studies are demonstrating an improvement. There’s burn scars, laser treatment, adhesion scars. You can see that there are also improvement. You can’t prove [inaudible 00:12:37]. It’s easy to put the positive and the negative. What it can do is show you 50 papers that show that PRP help scarring. I’ll find one that shows that it causes scarring. So if someone finds it, show it to me.
But how does this relate to what we do? If you do a procedure, let’s say you do a O-Shot and someone says their pain is worse, what do you do with that? For example, one of our providers is actually on the call, and I’m going to unmute her mic later, told me she had a patient who had back pain after an O-Shot. But when she got the asking, the woman had after the O-Shot, she was so excited about it, she and her husband had [inaudible 00:13:25] sex and she had injured her back. So the point I’m making is that if you see a magic trick, if you see a [inaudible 00:13:33] or a magic show [inaudible 00:13:36] appears so what you know is that something you’re not something about that situation.
So when someone tells you that their pain worsened with Platelet Rich Plasma or their erection got worse, it means that there’s something happening that we’re not seeing because Platelet Rich Plasma does not damage tissue. So the case of the erection getting worse, as far as I know, the cases about resolved when the person quit using the pump. So it wasn’t the PRP. I was the overuse of the pump. If you hear that complaint after a [inaudible 00:14:15], have them to stop the pump for a couple of weeks and them maybe start it back every other day or half the pressure.
For the O-Shot, I occasionally hear that people’s orgasms go down. I wish we had more data though so my guess is probably one in 500 something but I do occasionally hear someone’s orgasms seem worse. I only know of one where it never occurred and I don’t have an explanation for that. But you can make an easy case for why it might happen in the beginning because we’re vaguely created artificial hematoma. What happens if you have a hematoma on your arm, the sensation is not as great in the beginning. So why do some people have hypersexuality and more sensation and others have less? I don’t have a good explanation. But that’s my best guess at what’s going on and why it usually revolves [inaudible 00:15:14] it resolves and then they recover, get it back to baseline, or most of the time better than baseline.
So we have a consent form. We actually recently updated the consent forms. Our consent form’s always been strong but they used to always be more organized, more strengthened, and now we read part of this procedure. So you’ll see things listed that you’ve never seen. A long list of complaints and things that we’ve seen, we’ve added to the long list of complaints and we still include a line that says, “This is not a FDA procedure,” because some people still thinks the FDA approves procedures. So in the consent form, we say that it’s not. I’ll show the consent form list. So if you go into oshot.info and sign in … So when you get there, it’s going to look like this. I’m going to just pull it up really quickly. Then we’ll answer several more questions and then we have a [inaudible 00:16:25] promised to show you.
So you log in. This is the back side but when you log in, you’ll see something that looks like this. This is where I’m really begging you guys. The more the survey data we get, the more we’ll understand, I think, how often some of these things happen and what’s the [inaudible 00:16:44]. Once again here, you’ll see the legal when you go to legal. Our new consent form is there and this is me describing the routine, which I’ll get into now and how to use it. So there’s the consent form and we’ll just finish this out now as far as the scarring goes. As far as I know, saying that you damaged something with Platelet Rich Plasma is similar to saying that you have suffocated from oxygen because logically, it’s hard to understand since Platelet Rich Plasma remodels things back into a normal [inaudible 00:17:22].
But here’s the consent form and I’ll put up … You see it’s pretty straight forward and you can see there’s as long line of things. Basically, it just listed everything we could think of that a person complain of because do we say that PRP doesn’t cause fatigue. We haven’t done 10,000 people with a [inaudible 00:17:45]. But we do have almost 10,000 papers. Let me just pull this up again for you guys to realize. If you got to pub med and put in Platelet Rich Plasma, I think it’s interesting to see the body of knowledge. When I started doing this eight years ago, this used to be 5,000 personnel [inaudible 00:18:08] and just [inaudible 00:18:10] exploding.
So back to the video. There. So you can see we put the pen and we also put that we don’t really know. Something can happen we’re not anticipating. I can conservatively say that if you look at the number of people we have, the number of procedures we’re doing, we’re at 2,000 procedures by now easily, just O-Shots alone. The region company alone says [inaudible 00:18:44] PRP kits for a year so the number of procedures that PRP is phenomenal. Millions of procedures done yearly. Yet when you look at pub med, you cannot side one serious side effect. Not one serious thing that’s happened except recently when they had something bad happen in the eye. I can find the [inaudible 00:19:08] report [inaudible 00:19:09] mixed something weird with PRP [inaudible 00:19:13] and it got an infection. But you can’t blame it on the PRP. It sounds like some sort of home [inaudible 00:19:19] or something.
As far as the PRP procedure, [inaudible 00:19:24]. So when I show people this consent form, of course I sit with them and I tell them that these are things to go wrong and we don’t really know. We’ve done thousands of procedures and so [inaudible 00:19:38] at all. There it is. So that’s the consent form. Now back to this [inaudible 00:19:45]. Let’s say that someone does not get … David just put something here. Let’s see what he says.
Okay, so, here is me at one of our workshops talking about why I’ve given money back. As far as I know, anybody that I’ve ever seen since I went to cash procedures in 2003, I gave … [inaudible 00:20:22] PMD stats, so 15 years ago … You know as far as I know, anyone who was unhappy with a procedure that I did, I returned every penny that they gave me.
People get nervous when I say that, but, most people are not dishonest. Yeah, people have stolen from me, people steal from me [inaudible 00:20:40] sure. I run my life … Although I don’t make it easy for people to steal from me, if I base my whole life on keeping people from stealing from me, it would not be a pleasant experience, and I would not be able to freely give as much, or offer as much. If people are mostly not … If they were mostly dishonest … If most people were dishonest, Walmart would be out of business in one week, because they have … Since opening, they had that 100% money back guarantee for anything you return.
Why I Give All Money Back ANYTIME ANYONE is not happy with the results…
Even when I did weight loss, and I would have 3 weight loss classes [inaudible 00:21:18] did a lot of weight loss there at one time. I had a guarantee that you could have every penny back you had [inaudible 00:21:28] doctor fees up to 365 days from starting the program. And once or twice a year someone would want all their money back, but, having that made me more careful about who I took care of. I didn’t want to take the reverse side of that equation, I was careful not to take money from people I didn’t think I could get well, but I would take money from some, and still do take money from people occasionally.
Here’s the interesting, other flip side of it, or aspect of it is that if you are ethical, and as far as I know everyone in my group is ethical, or I would have asked them to leave the group … But, I feel like we have a very ethical group, and if you are ethical, then you will sometimes hesitate to take care of people if you’re afraid it won’t work. But, if you have in your heart of hearts that you know you’re not going to keep their money if it doesn’t work, and your cost of goods is relatively small, so that you’re going to make your money back on the next procedure, then what happens is you are actually more willing to take care of the harder cases.
Just make sure you don’t care of all hard cases. Just mix it up so that you mostly take care of the easy cases that you know you can get well, and occasionally take care of people for free, as we all do, or take care of the hard cases when you know your likelihood of getting them well is less than 50%, but you have enough mark up on your cost of goods that you’ll still be profitable in the next procedure.
So, you can hear me talk more about that there if you just log in and go to Legal, and here’s the receipt that we use. And, again you can get your … This is sort of my disclaimer, so you should … My attorney requires me to say to you, I’m not your attorney and you should have your attorney look at this. But this is what we use in our office, and it’s very simple, just two lines.
So, when someone has an outcome that’s not what they wanted, then I tell them come in and Let’s talk about it. And I’m very sincere about that, and I try to see what else might help them. If it’s not something that I have to offer that would help them, then I say “I’m sorry that this didn’t work for you, and there’s no way I want to keep your money if you’re not happy with what happened here. So here, let me write you a cheque.”. And I write them a cheque for a full refund, every penny of it, and then I have them sign this. So it says “I’ve had no adverse consequences from the … Whatever procedure … On this date. Because I’m not realizing the benefit, subjective benefit, I’ve been offered and accepted a full refund of this many dollars on this date.”
They sign it, and my nurse signs it, and we’re done. And then everybody’s happy, they don’t feel like I ripped them off, and I’m not just giving them a receipt, as you can see, I’m making it so that we’re legally also clean from each other. And, I very ethically, put my full brain, and all of my volition into helping them find another alternative, because they would have not given me this money if they didn’t have legitimate [pain 00:24:45] that’s bothering them.
And by doing this, some people have this idea erroneously that if you return money it’s making you subjective to a lawsuit. Not so, again I’m not your attorney, but all the attorneys that specialize in med spas and medical care that I’ve spoken to say not so.
Any time you are doing your best to not harm people, whether it’s medically or monetarily, you are making yourself less likely to have litigation. I get a dirty letter or an email from someone who’s angry about one of our providers, in every case it will be that the provider … Not only did the person not have the outcome they wanted, it’s that they didn’t get their money back, and they feel like they were ripped off.
So make use of the receipt, it sits right here on the Legal page to be downloaded. And make sure that you do mostly a high likelihood of success procedures, which are listed on these recent post on the CMA, and our How To Do web pages.
So that’s the receipt. What else am I needing to cover. I think that’s the main things from [inaudible 00:26:09] the things [inaudible 00:26:11] by email. I have a few more questions, but let me handle some from you guys for a second. Let’s see. Actually, David let me … let me get to that in a second, because I have another question here that I want to cover.
So this one has to do with hair. I’ll just let you look at it. The question that was sent to me. So it says “Hi Charles, I’d like to pose the question for [open mic 00:26:43] discussion.”. By the way, this is a … If you cannot make one of the [open mic 00:26:46] discussions, this is the way … This is a nice way to send it. Just email it, I’ll cover it when we do the webinar, and then it gets recorded and transcribed. So “I’d like to pose a question, what’s the latest on adjuncts for treatment of hair loss with PRP?”
Treatment of Hair Loss
A couple years ago we were using [ACell 00:27:03], vitamin D, and vitamin B, and still this is the recommendation. So, the .. Of course, [Dr. Harrison 00:27:12] reads the research, you guys read the research. The question is am I hearing anything from the grapevine because I’m in the nice of position of being able to get email from all you guys, that are brilliant and out there working, and so it makes me switchboard, and I’m always taking notes.
What I can tell you is I am not hearing any great new recipes. Most people have dropped the [ACell 00:27:35] out of their recipe. Now if you go to our [inaudible 00:27:39] website, on the How To Do page, we have a recipe if you want to use it, from some of providers [inaudible 00:27:45] where they mix vitamin D, and B complex, and other things.
But the [ACell 00:27:51] bothers me because it’s an animal product. You know, it’s a pig bladder matrix. And I was in a research protocol where there was cross immunity to a small pox vaccine that was grown on cow … Cow pox, and we were testing a genetic [recombinate 00:28:10] version, and I had someone who showed up with a myocarditis from that cross-reactivity. And they eventually stopped the study, so who knows how many of us got myocarditis back in the day, when that was the way to vaccinate for small pox.
The point is that, I can tell you that there’s [inaudible 00:28:28] paper showing no side effects from using PRP. I can’t tell you that about [ACell 00:28:33]. I don’t like what it does to the possibility of something going wrong, and, I just don’t use it anymore.
So, I did pull up a couple of papers here, and I’ll just let you see some of them, to let you see … What’s … These are, I think, representative of many more. So, if you look at this … The word is out, is what I’m getting to, is that it does work, and people are mostly using it as a [inaudible 00:29:10]. The … As far as [inaudible 00:29:15]. They mix … They’re doing it in combination with laser for the hair, you know the laser caps. They’re doing it in combination with … With Minoxidil, or Finasteride, as you can see here.
But in this study, these are people who failed topical Minoxidil and Finasteride, and then they gave them PRP, and they had a response. So, in this group, they went 3 monthly sessions followed by 3 [inaudible 00:29:43] monthly sessions, and that’s what I usually see. Some … Once a month [inaudible 00:29:49] 3, and then every other month, then once every 6 months. It gets a little bit more variable after those first 3 treatments.
Here’s another paper. And again, so in micro … so instead of injecting, they’re doing micro-needling with PRP versus topical Minoxidil. So I get that question a lot. Should you micro-needle it or should you inject it subdermally, or what do you do with it? And I just do everything. I’d goes … I block it by doing a little ring block, which is on our website. And then I do subdermal and then micro-needle [inaudible 00:30:28] to play with the core on top. That’s how I do it. And when I see the people who come from the hair clinics [inaudible 00:30:32], that’s what I’m seeing them doing.
Now those who are hair transplant surgeon, I heard lecture at one of the venues, said women are very responsive. He just treats them once and tells them to be patient. So I haven’t seen this study yet, that says that one treatment, the patients needs to wait six months to a year. I haven’t seen the study that shows one treatment and then wait a year versus a treatment … [inaudible 00:30:57] a lot of times three and wait a year.
So who knows who can do that. We’re over treating the need to do the next two. We just need to do one treatment, wait in women. But the common thing with women, that seems to work best that I’m seeing it do … subdermal injections, micro-needle on top, PRP on top of it, put them on 2% Rogaine, tell them to be patient. And yes, most people are doing that, followed by another treatment in [inaudible 00:31:26]another treatment after that. That’s what I’m hearing is the protocol and I don’t see any other magic mixtures. It’s still out there [inaudible 00:31:36]scalp studies and they’re showing nice results even for alopecia [inaudible 00:31:40] it works better than trying Tryptizol alone, so that’s for hair.Let’s see … Some of the websites had some questions too so let me get back to those.
So this one says, “Is it okay to use a laser light for treatment on patients who had a P-shot or hair restoration?”. I think that a topical laser light to help hair growth is of course something you could do starting immediately and that has been shown to help as a stand alone, and so, I haven’t seen it with PRP, with laser cap versus no laser cap but it will make sense that if either one of them works alone it might work better combined because this is not a heat treatment. It will be different if it were [inaudible 00:32:36]sort of laser like[inaudible 00:32:39]laser or pixel laser where you’re actually [inaudible 00:32:44] tissue like a [inaudible 00:32:45] with vagina, in that case you want the heat to go first followed by the PRP immediately and I would give at least four weeks before I do another PRP treatment or another laser treatment because you have to give … I think the pluripotent stem cells time to develop, and the soft tissue studies I see they seem to max out at about twelve weeks with most of the time eight weeks.
[inaudible 00:33:16]obviously studies that demonstrated that [inaudible 00:33:21]where with orthopedic procedures it’s a much longer time to maximal benefit with soft tissue I think you’ve achieve most of the benefit in eight weeks. Four weeks is the minimum amount of time that I would wait before I re-treated with laser because I think that’s undoing the progression of the benefit of PRP. So that’s that question. Let’s see what else we got.
Is Platelet Rich Plasma as Good as Platelet Rich Fibrin Matrix?
Got some more questions here.Okay, here is some. So this is a interesting question that I [inaudible 00:34:14] let’s do this one now. The question is ” Is there an advantage of platelet rich plasma over Platelet-rich fibrin matrix?”. And this to me a play on words or [inaudible 00:34:30] because everybody’s PRP turns into Platelet-rich fibrin matrix when it’s injected. Platelet-rich fibrin matrix is just the PRP growth factors con jelled into plasma and [inaudible 00:34:48] peptide chains that are in the[inaudible 00:34:53] are causing this [inaudible 00:34:53] to cause this matrix formation and that’s what causes the wound healing. But then some document out there that somehow that needs to be made in the syringe before it’s injected and the truth is that if [inaudible 00:35:07]in the tissue the inject PRP is exposed to collagen. The way I describe it to patients that’s the [inaudible 00:35:13]around the scab when you scrapped your knee, that’s what’s holding the tissue together when you’re healing a wound. Some people who sell kits that [inaudible 00:35:26] that matrix in the syringe seem to indicate that maybe that’s what needs to happen, I’m not so sure that’s the case.
The question then becomes, do you get adequate activation if you let it activate after you’ve injected and the platelets are exposed to collagen and then put in the matrix or do you leave it exposed to PRP and the collagen in the syringe and then inject it.[inaudible 00:35:55] has cure that comes with Calcium, so you’re activating the PRP before you [inaudible 00:35:58][inaudible 00:36:00]has cure that comes with HA that we can’t use here but it’s available in other places where there’s no FDA, where it comes with an HA which activates the PRP so you’re making the matrix before you inject it. Here we add calcium by the cals [inaudible 00:36:18] before we inject it and the ratio is .05[inaudible 00:36:23] 10 percent calcium chloride to [inaudible 00:36:28] of PRP or in other words divide the volume of PRP by [inaudible 00:36:32] and that [inaudible 00:36:32]volume of calcium chloride ten percent you should add.[inaudible 00:36:37] I do think you should[inaudible 00:36:43] you’ll get about, when you[inaudible 00:36:48] and you get closer to 100 percent activation if you add calcium chloride before you inject.So we’re activating [inaudible 00:36:55]substitution everything else we’re putting at 65 percent activation[inaudible 00:37:00] to that question is we are all making platelet-rich fibrin matrix anytime you use[inaudible 00:37:07] it’s just how you make it[inaudible 00:37:10].
Okay let’s see, we’re answered that one last time. Some of the videos [inaudible 00:37:23]behind the camera. Yeah that’s true, I’m sorry about that.[inaudible 00:37:29]I think if you look at the videos [inaudible 00:37:30] you can see everything by putting the videos together [inaudible 00:37:34]there’re sections of the videos[inaudible 00:37:40]and the truth is the people who come to our hands are [inaudible 00:37:43] do take it a different level. There’s something in particular you’re trying to see that aren’t available please let me know [inaudible 00:37:53]everything that’s build to be known by how to do it is there so if there’s something you’re not seeing tell me and I will shoot another video to take the place of the one the spot that you’re not seeing.Even though every second’s not visible every part is important about to do it should be visible. Okay so I think that’s all the questions on that one.
Let’s see, we may about to wind this down.We went through that one last time.We answered that one last time. Okay, I think that’s it let’s go through and see if you guys have question then we’ll shut this down. Let’s see Doctor [inaudible 00:38:33]has some prior questions.[inaudible 00:38:40]I’ll just let you have at it. Are you there?
An Orthopedist Talks About PRP
David: I’m here.
Charles Runels: Beautiful so, thank you for[inaudible 00:38:54]the interesting questions, tell us what you’re thinking and let’s just[inaudible 00:38:59] what is on your mind if that’s okay.
David: [inaudible 00:39:06]I wanted to tell you that[inaudible 00:39:18] my son with whom I’ve done PRP, came home with[inaudible 00:39:23]surgery for twelve years longer going through more [inaudible 00:39:29]
Charles Runels: Hey David, I’m hearing some really interesting stuff just breaking up a little bit and it sounds like a lot of experience to share with us,there anyway you can get closer to the mic or fix it where we can hear you a little better because it sounds like [crosstalk 00:39:49] this could be very valuable.
David: Let me open the[inaudible 00:39:52]in my computer and maybe that’s better. Can you hear me now-
Charles Runels: That’s better, whatever you just did made it way better. Maybe you could start over if you don’t mind.
David: Yes I had replaced my laptop so was using my other screen.So as I said, I’ve used my son and my wife as guinea pigs for PRP and stem cells recently, but I’ve had 12 years of orthopedic experience. Is that coming through over the email?
Charles Runels: It’s perfect now, and it’s very valuable. We’re interested in those 12 years of experience.
David: So I’ve got 12 years of experience of using bone marrow concentrate amniotic material, PRP in all forms and fashion from every vendor, and as you know, I recently converted from being a cutting surgeon to being a non-cutting surgeon and moved into the alternative realm. I recently got back to Tucson from the AMG meeting, so we kind of focused a lot on the cosmetic side as well as peptides.
Results of my son’s tennis elbow, he’s had five years of tennis elbow after Hurricane Rita and using a chain saw to cut down two trees in his backyard, and came to me and said, “Dad, can’t you possibly un-retire enough to operate on my elbows?” I said, “No [inaudible 00:41:09].” I said to Austin, “I’m gonna inject ya in my clinic with this new PRP I’ve got. We’ll see what happens.” Well, in five months, he called me, and I won’t use the profanity, but he says, “You got a blanking cure for this. You need to advertise it. [inaudible 00:41:22].” I used your technique and just used it on his elbows.
One thing he did tell me, he says, “That hurt like hell.” He said, “I can’t recommend it to anybody unless you find a way to make it not hurt so bad.” We’re looking into nitrous oxide, we’re looking into topicals a little bit more, and whatever. I just don’t want to interfere with the [inaudible 00:41:45] of the platelets, so any suggestion you might have on that, that you can publish for us it can help us be humane would be good, his orthopedist worked on a [inaudible 00:41:55] and we don’t care too much, but I think it’s better for the cosmetic world for us not to hurt people.
Charles Runels: Yeah, sure. Well that’s a lot of … keeping going because in 12 years you’ve got more to share than that, keep going.
David: I don’t want to burn up the hour, but the …
Charles Runels: No, no it’s good. I’m through with all the questions, I want to learn from you.
David: Well, I also reported on my wife’s recent O-Shot and that she did unbelievably well for ten days and no leakage whatsoever, we’re married 46 years, two kids, a 45-year-old, a 34-year-old and we’re physiologically young, but she’s had some incompetence, she’s got a [inaudible 00:42:36] some other things, that I said, “Look we need to try this, this isn’t so much for orgasm and libido, it’s for your … whatever, I wanna find out what happens.
She was dry for ten days, with no problem with jogging and trampoline and everything else, which was a big change. And then she kind of had a regression back. She says, “You know I think I may be actually leaking more now after ten days.” So I kind of just [inaudible 00:43:03], sometime I don’t much, whenever I get it back a little bit, just wait. And I ask her finally and I said, “So are you still leaking?” And she says, “You know I’m not.” And so I think as you said before you got to look other places for problems sometimes [inaudible 00:43:24] we’re so used to in medicine, the most critical people around for our own selves.
Charles Runels: Let me see if I can explain, again we need the ultrasound studies to prove this. We have two … excuse me, we have three now [inaudible 00:43:38] radiologists in our group and hopefully they’ll do these studies for us, but here’s what I think you just described. So if you think about it when you do the procedure, you obviously, there’s no time for cell growth you get those [inaudible 00:43:56] and all that. My best explantation for what I have … resolution of confidence immediately, which doesn’t happen to everybody, but happens a lot is that we are forming that [inaudible 00:44:10] matrix and it’s acting like liquid sling and stopping the [inaudible 00:44:15] immediately.
Of course, that’s like what happens to the scab on someones knee, this is what I explain to patients, you know it could go away immediately but it may not, which is making the hematoma, and [inaudible 00:44:28] resolves though, the actual tissue growth doesn’t really start until at least when you’re doing cosmetic work, you can’t see that much until around the third week with like at 12 week.
So what could’ve been is that the matrix was there, stopped it, which is great and I love when that happens even though it sometimes [inaudible 00:44:48] it tells you, you put it in the right place. But then it could go away and when it came back that’s the true cell growth. Now the other thing that just to add to your story and again, I’m making this up, I think this is probably the right thing based on what I’m seeing and about the science of it, I could be wrong and I’m the last person to say everything I’m telling you is right. We need to do the research to figure it out, but your story you just told is very common.
The other thing that’s common is that sometimes it will go away, but sometimes it’s just better, but it’s not all the way gone in that [inaudible 00:45:27] and when that happens just repeat it, it’s so common for it to be better after the second shot even the sex part, sometimes the urine gets better and the sex isn’t better after shot two or three. It’s so common I’ve even thought about just making it a standard protocol that everybody gets two shots because, that to me seems unfair since many women would be improved or as well as they need to be and are, most of them actually around 60 percent last time I surveyed, 60 to 70, depending on the problem.
And then it jumps to 80 to 90 plus after the second one. So it kind of seems unfair those people, the 60 to 70 percent to require a second shot or make them pay for a second shot and may not need it. So having said all that I think that’s my best bet about what happened with your wife, I just wanted to throw it in, but keep going with your experience … we want you to teach us, because here’s the thing the [inaudible 00:46:23] were ahead of us with the PRP and if you’ve been doing it that long you have other things to teach us, so go for it.
David: Well I can tell ya I probably started doing these alternative methods with [inaudible 00:46:33] this and I still … up till February last year [inaudible 00:46:37] this trauma. I mainly, sports, but a lot of trauma. I never had another non union [inaudible 00:46:46] fracture after putting PRP or [inaudible 00:46:49] or bone marrow concentrate in those fractures. It was very, very helpful also with skin cut bridge [inaudible 00:47:00] skin loss and muscle loss, that helped tremendously. What got me to that comment was if you do, do a second one, do you fully or do you charge a reduced price? Or do you give it to them, how do you handle it?
Charles Runels: Okay, so that’s a good business question. I don’t like to tell people, well this is the standard thing that everyone should do, because you’re the one looking at your patients. But I’ll tell you what works for me with most of my patients, if they have a nice result, their [inaudible 00:47:41] is mostly gone and they’re happy with it, but they think, I think it would, I may want another one, most of those people want to pay you again, they realize that it worked, they just want to see if it works better. They want to pay you and so they should, let them. If you want more, you should pay me again. But, I would insist on it if they’re attitude or their, if my feeling about them, their communication to me … it’s not [inaudible 00:48:16] that they feel like they go their value for their money, then I’ll do the next one for free.
[inaudible 00:48:24] it’s not a four hour procedure, it’s fairly quick and our cost of goods are reasonable enough that you’re still profitable, so that’s where I am on a case by case basis. [crosstalk 00:48:38]
Don’t make that decision until it’s been at least eight weeks. And really chances are that they may get better at 12 to 16 weeks if they’re not better at eight, still kind of pushing it. To me it feels kinds of, maybe not so far to them to make, 16 weeks that four months. So do I really want to make them wait for a third of a year before I decide if I’m going to retreat it when they’re leaking down their leg, knowing if I retreat it, it may go away and so it’s sort of judgment call, but one things for sure I would make them wait at least eight weeks because I might need to subject them to another procedure or draw their blood and all the things that go with it and whether their paying me or not there’s some cost of goods and some time involved, break times valuable too. So I would tend to wait at least eight weeks before [inaudible 00:49:34] did work.
David: Excellent, with respect to, to my bias coming from orthopedics and coming from PRP and moving into bone marrow and [inaudible 00:49:44] back into [inaudible 00:49:46] and PRP I think I consider I can say pretty … opinionated that stem cells in some form of fashion, I call it stem cell signaling, just so we don’t get [inaudible 00:50:04] with our big brother but the signaling factors and growth factors that come out of stem cell in my opinion are probably big brother and PRP his little brother and we know that there could be 600 drug factors in the stem cells, PRP or bone marrow and there’s probably 300 drug factors in PRP so maybe it’s not that big of deal, pretty even. In somebody that’s a little bit more aggressive, for example my wife had Hallus Rigidus, which is loss of the cartilage in the metatarsophalangeal above the big toes and ready for either fusion osteotomy to remove the cartilage around or arthoplasty and she was on the surgery this time last year, I chose to go forward [inaudible 00:50:55] as a guinea pig my first case after getting back to California and studying lipogenic stem cells and I injected both of her big toes.
The chronology of that is that four and a half months of bated breath she got me and says, “I think my right toe is better, and if I’m not.” She says, “My right toe is definitely better and my left toe is better.” I know exactly when I did this, because I did it a week before the election a year ago and she is now admittedly, somewhere around 75 to 85 percent better in the bad toe and 95 percent better in the good toe and she is extremely happy, I don’t have any claims about regrowing cartilage or anything like that. All I know is symptomatically she can wear high heels and boots and she can jog the hills in Austin, Texas and she can go into yoga where as she could not pull forward, she was putting [inaudible 00:51:52] and everything else on her big toe four times a day and she was miserable. She grabbed me by the throat she said, “Look you’re supposed to be smart, do something.”[crosstalk 00:52:01]
Charles Runels: Obviously that’s anecdotal, but it’s traumatic. It’s not just anecdotal, because you know better than I having been in the ortho world. There’s hundreds of papers, probably thousands of papers in the orthopedic literature backing up exactly what you just said, so it’s not like you’re just pulling that one out of your hat.
David: [crosstalk 00:52:31]It’s really about [inaudible 00:52:32] fractures.
Charles Runels: Along those same lines, I know that most of the people on this call, many of them do treat orthopedic cases, most do not but what you’re saying is very relevant because it all has to do with tissue healing and thinking [inaudible 00:52:47] timeframes and what’s possible and what isn’t and that’s why I’m bringing up this picture that many of you guys have seen before. This from that, which is fairly extensive hypertrophic scar from Cortisone that had been there for a year to this a year later and it still looks like that seven years later, this was six years later, I did this in 2011.
This Juvederm with PRP with no stem cell transfer just recruitment of stem cells from PRP, from the Juvederm as a matrix on which to build the new growth. So if this is going on when we do O-Shots and P-Shots and faces then obviously … and it should be. There’s some intelligence about the process that’s beyond our skillset as far as what we’re actually doing with that needle.
And the other thing you brought up about the malunion … horrific thing that happens sometimes. I had to cases that came to me when I used to do clinical trials with [inaudible 00:53:58] from one woman who had been operated on six times they were considering an amputation, operate six times on her shoulder. They just couldn’t get her humerus to heal and she had an IGF-1 that was less than 60, it was almost in the dirt. She literally out of desperation, because someone told her to come see me and then I had another case with a woman who had an external fixator that had been operated on three times and in the process of doing that research [inaudible 00:54:38] stem testing for growth hormone deficiency, which you know is measured by a [inaudible 00:54:43] which is one of the well factors in PRP. That’s released by the [inaudible 00:54:48]. In both of those cases I put them on six weeks of growth hormone replacement, got their [inaudible 00:54:56] back to normal sent them back to the surgeon. And it’s anecdotal, but in both of these cases the next surgery went well.
David: That’s awesome. My last little caveat and then we’ll stop, which has to do with the recent, it’s recent in the U.S. but not recent worldwide is peptides and we’re dealing with peptides in our PRP and in our stem cells but there are peptides now that can be used in conjunction with what we’re doing to target specific formalities that we’re treating generically with our PRP, which is good but there might even be better results we can send a messenger, via a 15 amino acid of peptide that’s in conjunction with some of these cells and [inaudible 00:55:49], because I am pursuing this like a mad dog right now academically to learn more about it. I’ve got about 25 or 30 years between my masters degree and all that stuff is old and there’s a big gap in my knowledge. But I’m gathering as much as I can, as quickly as I can so I can see where this fits.
Charles Runels: Let me add to that as well because when you [inaudible 00:56:13] it other people think that, not the people on this call, but the people we speak to, our patients think, oh peptides this sounds like something you put in their cream. Well insulins a peptide, [inaudible 00:56:25] a peptide, it’s why we have to have an injection, we can’t take it by mouth, because we would digest it. Where we can take estrogen by mouth, because it’s a [inaudible 00:56:35] hormone and it’s not broken apart by the acid in the stomach. Of course everybody on this call knows that, I just want to point out as you did. There are hundreds of peptide proteins made by the pituitary glands, so when we say peptides it’s not some second rate little “hokie” thing. We’re talking about powerful, hormone like messengers that attach to cells and tell them to do remarkable things and the idea that you can have that [inaudible 00:57:05] already there, packaged up for you in the perfect combination in those platelets is pretty remarkable. We don’t have, it’d be nice to know, which ones do what and understand it the way we do things like growth hormone and [inaudible 00:57:24] and insulin, but if we can make it work why are we trying to figure out which ones are doing what.
I just want to put in my hooray for peptides and we emphasize this is not second rate stuff, this is powerful stuff and it’s what we’re doing when we’re using PRP. The hours up, thank you very much Dr. [inaudible 00:57:48] I’m gonna see if anyone else has a question, if not we’re going to shut this down. I don’t see anything else, so. Thank you guys for showing up, I’ll post this video with a transcript, it will be up in a couple of days, well may be Monday with the Thanksgiving holiday. Thank you for [inaudible 00:58:05] and I think we’re really doing some good things for the planet. You guys have a Happy Thanksgiving.
Section 5 of 5 [00:40:00 – 00:58:16]
Cellular Medicine Association
Cellular Medicine Association
From an open-mike discussion sponsored by the Cellular Medicine Association (for our members only)
Transcript of Webinar<–
Charles Runels: So thank you guys for coming. We have quite a few questions. Before we get started with the questions, I thought it might be helpful to talk about what I call flow marketing, or you can call it vampire marketing, if you want, but the idea is that instead of trying to spend a lot of money trying to be how big you can be, it’s to [00:00:30] use something that’s already big, and then tap into that, to bring attention to what you’re doing.
Flow or Vampire Marketing
For example, when something is hot, like when I came up with the Vampire Facelift name, all the vampire movies were popular at the time, and so it helped promote our name, it blasted off, and then by that same token, for example right now, it’s the Halloween season, [00:01:00] so you’ll start to see things like this. This came out today. October 4th in today’s New York Post, and every Halloween the news loves to talk about our procedures, but the vast majority of our people never take advantage of that. Consider another way to think about this is think about this would be like you are tapping into … It’s like putting your paddle, your windmill in [00:01:30] the wind, or putting your paddle wheel in a stream.
So whenever everyone’s, a lot of people are thinking about Halloween, that’s exactly why you’ll see the newspapers start talking about Halloween stuff, because they also know that that’s going to bring a lot of readers, which is going to make people click on their ads, which is why they stay in business and get to buy groceries, [00:02:00] by having a website. So you can do the same thing. Now, if you go onto our … Well, let me give you specifics of what I would do right now.
This is the time to take something like this, and I’m going to put this link into the chat box, and I would take this link and put it wherever you’re putting things, like you can put it in your … Okay. Wait a second. Let me paste it. [00:02:30] There it is. So wherever you can put that on a Facebook page, if you have it.
Here’s 2 Pages to Share if You do the Vampire Breast Lift…
You can go into an email that can be simply three lines. It could say, “Hey, check out this thing on the New York Post where they were talking about increasing or improving the appearance of the breast using the Vampire Breast Lift, similar to the Vampire Facial.” So what you’ll see is our procedures all promote each other.
So for example, on the Vampire [00:03:00] Facelift website, I have a link that goes to the O-Shot. On the O-Shot, there’s a link that goes to P-Shot and back to Facelift, so they’re all talking to each other. It’s very similar to, say if John Grisham has a book, the best way he sells all his books is to come out with another book and then on the back cover of every book, there’s a list of all the previous books, so if you happen to read one and you like it, you’re going to read the others. So that’s how this works.
I call it flow marketing or vampire marketing, where you don’t [00:03:30] use your energy. You tap your marketing into someone else’s energy. Now I put a whole video just about that. I want to show you. If you go to the Vampire Facelift page or the O-Shot page, and then you go to the marketing part. I’ll just go. Let me log on. I’m on the O-Shot webpage. Let me go to the marketing so you can see. Then I’ll come back and answer some of these questions.
[00:04:00] Of course, is just you want to take care of your people, which our people do. That’s why the people who go to the extent to learn new techniques spend the kind of money and time that you guys do to try to take better care of your patients. I’m preaching to the choir, but the thing that doctors do forget, and I have to remind myself sometimes, is that it is not your patient’s [00:04:30] responsibility to know what you’re able to do, so I’m going to say that again. It is not your patient’s responsibility to know what I’m able to do. So lots of us don’t really enjoy making videos, including myself. I do it, I don’t pay as much attention to it as I used to. I’ve become more deaf to the criticism that happens and always happens, but if you forget yourself, that’s being self-centered.
If you forget yourself and you think of only two [00:05:00] things, you think of the person who has pain that you know how to take care of, and you think of all the solutions you know, not just the thing you’re trying to sell that day, but all the solutions you know of to make that pain go away, now you forget yourself and you just become all about letting that person know what you have in the easiest, cheapest, best way because that means you have to spend less resources to get that message out, which means you can put out more messages, so this is not just marketing tricks. These are efficient, [00:05:30] ethical ways to help you heal more people who are suffering.
So that’s what we’re doing, and it’s not about making yourself look big. It’s into tapping something. So let me get to where you can see this. If you go into this marketing part right here, there’s a video that I’ve put up that you might want to see later. If you want to make a do list for this call, I would say one of the things would be go to this page, and go to [00:06:00] this one. Leveraging the national press to bring patients to your office. 41 minutes. Leveraging national press to bring patients to your office. You can also say that tapping your practice into this, so what would it cost you to put an ad in the New York Post? But there’s an ad in the New York Post. It’s an article, which is much better than an ad, but your patients maybe don’t see this page, and if they do, maybe they don’t know that you [00:06:30] know how to do that.
So I just gave you a simple way to take … I just put in the chat box. You can take that link that I just put in the box, and you could put that in a Facebook post, and when you do that, it looks like this. That’s how it shows up, and I’ll show you what that looks like so you could also just click this link, but you could also go to a page, so I’ll go to the Vampire Breast Lift page and let you see how this works in real time. So if I go to [00:07:00] our Vampire. We have a Vampire Breast Lift page. Where is it? Well, I don’t see it right now, so I’ll put it on the Vampire Facelift page. How about that?
So if I go to the Vampire Facelift® page and I just copy that link, so I’m just copying it out of the URL, and then I make a post, watch what the software does. So I just [00:07:30] posted the link, but then boom, it pops the picture, it finds the link and pops it in there, and now I can actually take this out and type something in. Do you see how you did that? You can do that very same thing with the link I just did, put that in your Facebook page, put it in your whatever, [00:08:00] and then yours, instead of saying up here, Just in Time for Halloween, you can say, “Offered in our office. Call us.” Tell people what to do. “Offered in our office. Would love to take care of you. Call us.” Something like that.
And then what they do is they say, “Oh, my doctor knows how to do this? That’s cool,” and then they call you. That’s called tapping the flow, and you’re constantly looking for what’s out there, not even what’s specific to the procedures you’re doing, but maybe they’re related, [00:08:30] so maybe Kim Kardashian or some movie star just did something that’s related to what you do, but not exactly, so then you could talk about that, and then say what you’re offering, so I call that tapping the flow, and along those same lines, I intend, because it’s Halloween time, to push and talk more about this month, I will be talking more about the Vampire Wing Lift because it’s time for something new.
We’ve all been following this, but many of us who do the O-Shot have been doing that [00:09:00] now for the past five years. I’ve been teaching it for the past four, and many of our providers have been doing that, so it’s time to start rolling that out and letting people know about it, so if you want to tap into that, if you go to our regular website. Let’s see. I’ll try to log in here. I’ll show you where you can see more about that because we will be talking about that this month.
[00:09:30] So we’re coming to questions. I just thought we’d start putting some marketing parts that are relevant and timely when we do these calls, and again, I always try to keep these less than an hour, hopefully shut them down in 45 minutes and they’ll be recorded and posted. So a lot of people were having trouble finding things. When you log in, this is our straight-up how to do the procedures page, but if you look to the side, what I’ve started doing is posting some of the blogs’ material over here, so here’s the [00:10:00] Vampire Wing Left [inaudible 00:10:02] labeled treatment-
Section 1 of 5 [00:00:00 – 00:10:04]
Section 2 of 5 [00:10:00 – 00:20:04](NOTE: speaker names may be different in each section)
Vampire Wing Lift®
Charles Runels: Vampire wing lift. Label treatments for orgasm, amnion, and then here’s some of the recent question and answer sessions. There’s last week’s sitting right there. So if you want to view that.
Really, really, useful, mostly about O-shot talk, where we interviewed Dr.Owings and Dr.Pose who had some very interesting things to say about the procedure.
Here’s about the amnion, which can be used for all these procedures. Talks [00:10:30] about it, you can order it there (that’s our special pricing) But here’s the Vampire wing life. I may not be able to do this, but I intend to make this (silence)
So [00:11:00] a video that shows you how.
The big thing I would say here, is that when you do this do not inject them separately. Mix the Juvederm in with the PRP, and it tells you how there. Mix it in with the PRP before you do this procedure so you get a nice emulsion and it’s not lumpy.
The other pearl I would say, is whatever [00:11:30] amounts of material you have put two thirds here and one third down here. So two thirds goes in the upper one half and one third of the material goes here. It looks odd and just looks unnatural if most of the material is down here. So that’s the way I distribute the material.
Okay. Vampire Wing lift, it’s a good time to talk about it. And this is the member side. If you want something to link to on the patient side and start putting something out there. Because whatever you put out there, [00:12:00] the first one to put out, search engines like it better. So if you just go to the patient side, and go to oshot.info and you want to tap into the Halloween thing. What you can do is you can make an email or a post and say, “Hey the New York Post is talking about the Vampire Breast-lift.” And you can see the actual article mentions the Vampire Facial, they goofed up and didn’t put our trademark there. So we’ll have to see if we can get them to correct that. But that’s okay they got our [00:12:30] name out.
But then in the same text you can say, “You might want to check out the Vampire Wing Lift.” And then if you go, same thing, now on the patient website for the o-shot. And right here I put a page, if you look in recent posts, I put a page over here, Vampire Wing-lift. So you can put a link to that page.
Now the thing about the wing-lift though, because it shows a picture of the labia, I would be careful [00:13:00] about posting this one to Facebook. It could be in a Twitter post, it could be in an email. But if you post this direct link to this page about the wing-lift … Well, it doesn’t’, it just has that video. So you could probably get away with it. If it had the picture then not so good.
If you play that video you’ll see why I have Rod Stewart in there. Wings are actually in one of his songs.
[00:13:30] And I’m going to go ahead and post this link, also. You can find it but I’ll go ahead and post that in the chat box too so you’ll have it.
Okay, I think that’s probably enough about marketing for now. Let me look at some of the questions.
Oh. I did want to bring up something that I think its huge, huge, huge, that a lot of people … I do it in my Hansel workshops but I’ve never had it on the [00:14:00] online workshops. I go through a little exercise here … I intent to post this to the memberships sights. And I recommend you guys watch this, and it will be in the marketing sections. 13 minutes about why you should offer money back on everything you do where you take cash. You will make more money, and you will have much happier patients, you’ll sleep better at night, life will be better for you in every way. People are afraid they’ll lose money by doing this. You will make much more money, and you will have much more patients [00:14:30] who are happy with you. And this tell you why and how to do that. And I will post this in the members section. So watch for it and I’ll send an email out when it’s done.
I call that marketing but you’ll actually wind up seeing more people for several different reasons. And you’ll see when you watch that video.
Okay, so I think that’s enough … Oh, one other quick thing about marketing, I promise this is the last one. I’m actually [00:15:00] in San Diego now, in a marketing class. Some of you guys who know me well know that I spend a lot of time and money trying to stay up to date so I’m sure I’m bringing you the best of the best. And I’m at a class in San Diego that’s put on my the Ontraport people. And some of you guys have signed up for Ontraport and maybe haven’t implemented. It’s huge, huge, huge what you can do with this. This is not just emails, and it’s not that complicated. But to implement please make use [00:15:30] of their help people. You just call the Naomi and know the guy the company, who started the company, and they take very special care of our people. If you call them after you sign up they’ll take care of you. Some of you have already signed up where I actually give you emails that were written in Ontraport, and there’s a reason I do that. Ontraport does things like postcards and a lot of other things that [00:16:00] A Weber and Constant Contact just can not do.
Even though I’ve use Ontraport for about seven years now, I haven’t really recommended it much until the past six months or so. Because I thought their tools were too technical and not user-friendly. But they’ve made them user-friendly. A good way to get started is just to go to oshot.info/tools and download this free book about how they think about emails. How they recommend it, [00:16:30] and then if you wind up getting Ontraport, I have a way of giving you 22 emails for free to send up. Go here, and sign up and read that thing, and implement it. It’s really easy. I’m going to put where that … I have that listed again in the chat box so that you can go get it.
Let’s see, hold on a second. It’s the same page where we sale other stuff, so some of you are already handing out books [00:17:00] and such. So that is oshot.info/tools. That’s where you get that free e-book.
I also still use Constant Contact, A Weber, Mail Champ, Ultra Cart, One Shopping Cart, Click Bang, so many different things. So when I tell you this is the best … Oh I’ve also used, Infusionsoft, and [00:17:30] I don’t know. I’m going to bore you if I tell you all of it. But too much money, and too much time. So when I tell you that this is the thing to do, I’m not guessing. I’ve spent money and a lot of time trying to figure it out. So oshot.info/tools.
And not everything that works for Mcdonalds or IBM works for a doctor’s office. So I’m telling you what works for a doctor’s office. And when I say that I mean ethical, educational, inspiring, helpful [00:18:00] ways that you can communicate with your patients and a side-effect is they know what you have to offer. And they’ll find you and not have to spend a lot of money doing that educational type marketing. So oshot.info/tools.
Okay. And when you get there, of course, there are other things that you can … Posters and such. But the main thing I’m telling you right now is go get this. And this is free by the way.
So I think it’s time to answer some questions now. And I’m glad we’ve got quite a few people on the call [00:18:30] so we can get some participation in getting these answered.
So I am on the … We’ll start with the Priapus Shot, it’s kinda been ignored for a while. So let’s go into Priapus Shot and see, here’s one of the questions, see what it has, and hopefully you guys can help me answer.
And I’ll just unmute your mic. If you have a question [00:19:00] ask that too. I see Dr.Kelly has one, I’ll get to you in just a second Dr.Kelly. Let’s see, okay here we go.
Here’s the question, “Per your above education. I think the procedures work better if you activate the PRP with calcium chloride except with micro-needling where the tissue injury releases enough Thrombin to activate. Do you believe that PRP hair restoration should also activate [00:19:30] with calcium as well, prior to injecting?” Anybody doing hair that wants to comment on that? I’ll unmute your mic for you.
So, here’s what I think. I think with all the procedures you could make the case that they may work better if you activate it. My thinking though is that we’re seeing great results without activating, when it comes to hair. [00:20:00] My reasoning is, unlike say the O-
Section 2 of 5 [00:10:00 – 00:20:04]
Section 3 of 5 [00:20:00 – 00:30:04](NOTE: speaker names may be different in each section)
Charles Runels: My reasoning is, unlike, say, the [O shots 00:20:04], where you need the material to stay within a few millimeters of where it’s injected, because you want it close to the urethra, with the scalp, that’s sort of the exact opposite. You’d like it to spread diffusely, so you don’t have to do as many injection points. As a matter of fact, if you inject too much when you do the hair, you can cause it to hydrodissect down, and the eyes can be swollen shut the next morning. Of course, it goes away eventually, [00:20:30] and everybody’s happy, but I’d hear of that happening.
So, that’s my reasoning. I don’t think it’s needed. We have a lot of people doing amazing work, and lots of good, raving reviews, who do not use the calcium. So, I would stick to when you do the O shot, the P shot, and when you do loss of sensation of the nipple, all for the same reasons. You want it to stay where you put it, and it’s more therapeutic versus [00:21:00] cosmetic. Again, part of the danger of teaching, if you start to believe everything you say, so let’s do the research, and help me figure it out. Someone should do that study.
Okay, next question. Let’s see. I think that was all on the Vampire site that was not … That was on the P shot site. Okay, so here’s one, okay. Dr. Gaskill. Let’s look at this. Give [00:21:30] some guidance how to know where there are active hair follicles. Is it necessary to do the microneedling?
So, you don’t really know, but as a general guideline, you can see where the hair used to be, and if someone’s just bald as a cue ball, [00:22:00] I’m probably not going to do it. Usually there’s a receding hairline, and some thinning. What I usually do is just go ahead and treat everywhere there used to be hair. I don’t try to delineate exactly where the living versus all-the-way-gone hair follicles, where that borderline is. That’s the way I handle it.
It’s because I have seen some people where I just don’t think there was no way something was going to come back [00:22:30] there, and it did. Even some of our providers. Then, on the other hand, you have people where you just think it’s going to be the bomb, and nothing happens. I’ve seen a couple people lecture. One guy, out of NYU, he wrote a textbook on hair. Saw him lecture out at Denison, and he said after years of doing this, he still has no way of predicting. No blood tests, nothing. He just treats people, series of three, but after the second treatment, a month after treatment number two, if he sees no [00:23:00] results, he stops. But, he doesn’t really know until he tries.
Of course, it doesn’t mean because there is that unknown, you check thyroid, and you think about … I do. I think about IGF-1, and nutrition, and all that, but even with checking all that, you still can’t predict many of those who will fail.
Okay. Let’s see what other questions there are on the facelift website. [00:23:30] Anybody want to add to that? Let’s see. Here’s one. Where can I get more info on amnion and the hand lift? So, the amnion, to actually see where we have it, talk about it in particular, if you go to … Let’s see if I can show this for you. If you go on the [00:24:00] member site, and then you scroll up here to where the blogs are … Right there it says Hand Lift with Amnion. I think a lot of people just haven’t done a good job of showing people where that lives. So, if you want to know what’s recent, then look under Recent Posts.
You can also see who’s commented last. There’s [00:24:30] about how to do it, and I had some questions about Amnion, so I answered that there. There’s a little seven minute video. Then, you can purchase it there too. The prices there will be shocking compared to what you’re used to seeing from the number one providers. Wherever you’ve been buying it, we’re most likely getting it from whoever’s supplying that … from the person that’s supplying them. I think that answers that question.
[00:25:00] Let’s see what other question there was. This page. Oh, this is back on Priapus Shot. Going to shut that one down. There wasn’t no more questions. Then, on the facelift, I think there was one other question. [00:25:30] Recently purchased the pure spin system … There’s two more questions. One about cannulas, and one about PRP systems. Recently purchased a pure spin. Been training with Dr. Runels online. The direct injection of the PRP into the dermis is extremely painful. Mix with bicarb. It’s on back order. Okay.
[00:26:00] Yeah, isn’t it crazy that our laws … Every time I get one of these questions, it makes me sad that our laws are such that … Realize this is salt water, basically. Bicarb, calcium chloride. These are not narcotic, addictive things. These are not difficult to make in a sterile way. But, because of the rules with the compounding pharmacies, this makes salt water hard to find. It’s actually heartbreaking, to me. The place [00:26:30] that I go to that seems to be always, either they have it, or they can get it quickly, is … [inaudible 00:26:39] if you go back to our how to do it page, you go to the dashboard, and then you go … Scroll down to where I buy everything. Then, right here, it has all of it. It has my source, and it has [inaudible 00:26:57] phone number in there. So, that’s [00:27:00] where I would go.
After that, I really don’t have a good answer. Now, for the calcium chloride, you can also go to mrcrashcart.com, or whoever’s stocking your crash cart, and use those ampules, because that’s also 10% calcium chloride.
Let’s see. Think there was another question. Oh, it was about cannulas. Let’s see what the question was on cannulas. [00:27:30] I get that a lot. I can just start ranting about it, but I want to make sure that we answer this particular question. The general principle that applies to this, I think, and I see our expert injectors are divided about half and half, is that when you use a cannula, if you think about it, you have to make a small puncture [00:28:00] wound to put the canula through.
When I first started using PRP, I tried to use it like Juvederm, where I tried to lay down retrograde, or a line, do linear lines, or I would do little fans, like you do with a [hyaluronic acid filler 00:28:21]. Imagine if you had a bucket of water, and you’re trying to cover the floor with it. You wouldn’t feel inclined, or need to do that at all. You just pour it, and it would spread. I [00:28:30] found that that’s really what you can do with PRP. Instead of having to retrograde a line of hyaluronic acid filler, for example. Through the tear trough, you can just make a little puncture wound, and my needle doesn’t pass any further than it needs to go to put the lumen all the way through the dermis.
Then, I inject and it hydrodissects everywhere it needs to go, which is what you would have to do. You would have to make that same hole to put a cannula through, so there becomes no need for the cannula, which is why I don’t use [00:29:00] them for PRP.
Let’s read this question. Two questions. What are your thoughts for using cannulas for PRP. That’s it. When I talked about hyaluronic acids, I realize there’s a different reason for using them, and what I see there is our providers are probably divided in half. About half use them and half don’t. I usually don’t, just because I trained without them, and usually do not bruise people, or worry about necrosis, [00:29:30] because I’ve trained learning how to do it with a regular needle. But, I don’t have any problem at all with using them. I think that people who like using them should keep using them.
Next question. As well, I have a patient with very mild acne pitting, with slightly darker skin. Do I set my speed faster and depth deeper with microneedling? How many treatments, and expectations?
So, I talked with a guy who actually invented one of [00:30:00] the pens, one of the major name brands. He said that-
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Section 4 of 5 [00:30:00 – 00:40:04](NOTE: speaker names may be different in each section)
Charles Runels: The pens, one of the major names brands. And he said that they found that more holes is always better. And the only reasons they put three speeds on the pen is because they knew if they only put one speed, that others would brag about how they had a three speed pen and his company only had a one speed pen.
To me, it’s similar to your blender. You know, there’s a frappe and a whoope and a soupe and I don’t even know. Those 16 button blenders, is there really a difference between [00:30:30] button 10 and button 12? I just don’t have one, I have a blender that has one switch, on and off, and it’s got a steel bar that connects to the whirling blades. I think you could grind nails with it. When I turn it on it’s just wide open or it’s off. Maybe, it has a low, I don’t know, but it’s just one switch.
That’s the way I would think about your microneedling device. Just, turn it as fast as it will go [00:31:00] and as far as the depth goes, I don’t think it relates so much to the color of the skin. As a matter of fact, one of our providers, Dr. Lubin, up in New York, is treating and has some really beautiful pictures where she’s treating keloid in dark skin, with microneedling. I don’t think that really matters. I think that what matters is that you look at what you’re doing and you vary the depth, such that you’re getting [inaudible 00:31:29] hemorrhaging [00:31:30] as in going all the way through the dermis.
As far as expectations and how many treatments for someone with acne, I would plan on doing a series of three, about four to six weeks apart. The other little pearl of this is that, I would go ahead, even though it may not be part of what they came for and even though it may be a younger person, consider adding some volume to the cheeks and wherever it might need it using Juvederm or hyaluronic acid filler because adding [00:32:00] volume before you even treat the pit, pitting acne, is going to make those pits more shallow, just like if you blew up a basketball, the little holes are going to become more shallow because of inflation. Before you even directly treat the acne scars, they become more shallow, just because you add volume. And the expectations would be, I never tell anybody that things will go away but just that they will be improved and you can promise them, that they will be improved. They will like it and it will be softer [00:32:30] and less noticeable after you are finished.
All right, I think let me slow down here, because we’ve got some people commenting. I’ll start at the top and we’ll start with Dr. Kelly. I think I’m just going to unmute, Dr. Kelly, if you don’t mind. Let’s just let you ask your question to the group in a second if I can get this done. Here we go.
So Dr. Kelly is gynecologist out of the Atlanta area. She one of the, way back in the day came to see me [00:33:00] early on and trusted me. Has been doing the procedures for quite a while. I’m glad you’re able to log in. Tell us how it’s going and what’s the question.
Linda Kelly: Things are going well. Thank you very much. Can you hear me?
Charles Runels: Very well.
Linda Kelly: Okay. I had a question about whether or not anyone has used PRP in other areas of the body such as in the buttocks or a lift in that area, along with sort of like a vampire butt lift. Used it for cellulite [00:33:30] or anything. I just wanted to hear from the other doctors.
Charles Runels: I’ll see if anyone raises their hand and I’ll post this on to the websites. As you might know, we’ve talked about this before and I’m glad you brought it up so we can see what other people say about it. But, I normally will treat the lower part of the buttocks, that will roll right above the leg, like a Vampire breast lift and try to put at least 10 or 15 ccs preferably 15 mls of [00:34:00] PRP on each side and that fluffs that out where it’s rounder and I’ve treated quite a few people who’ve had divots in their buttocks from a cortisone injection and I don’t even mean Juvederm. If you just put 5 ccs of PRP in that, somehow it just knows to fill in and it won’t overfill and it looks beautiful and it’s permanent. I have people that, one of the first things I ever did with PRP, on the very first day, someone came. I put it in, not knowing if it would work, it worked great. There’s a lady on my staff, that’s been with me for several [00:34:30] years, same thing, just injected PRP in that area so the fat in the buttocks, just like in the breast, goes crazy with PRP. But somehow, it knows what level to go to genetically and it doesn’t overfill or underfill.
But, I don’t see anybody else raising their hand. I’ll post this to the website, Linda and see if anybody else comments on it. I know for the, I’ve had quite a few people, I don’t think any of us are doing this yet, but I’ve had quite a [00:35:00] few people tell me and they always just start ranting about the results from microneedling in post partum stretch marks on the abdomen. I know being a gynecologist, you probably have a few of those ladies around and they just rant over and over again about how wonderful that works, microneedling with PRP for stretch marks.
I’m just going to leave you unmuted, because I know you’ve been doing this for a while and might help us with some of these other questions. Would you have any, if someone was [00:35:30] just starting out, when you started out, our marketing, we didn’t have this much attention, nothing like this much attention when you first come to see me down in Fair Hope, so any tips you would give them as far as what you did right in marketing and maybe where things didn’t work so well. I’ve never even asked you this question before, but I was [inaudible 00:35:53] anything that you would say about what work well for you, what maybe did not work so well with you work.
Linda Kelly: I [00:36:00] really do think, with someone who is a celebrity, has had an experience with the procedure that piggy backing off of that, it makes a huge difference. People were interested in that and it, there were people who did not like the name Vampire Face Lift, here in Georgia, but there are people who loved it, so it’s kind of a different clientele that we were attracted to the practice because of adding that. Everyone loves the microneedling with PRP, I [00:36:30] mean, it’s really just, it’s been amazing and it’s one of the most popular procedures at my office, now.
Charles Runels: Beautiful. It’s interesting, it’s become accepted but you’ve been with me long enough to remember, when we first started using that name, and you don’t hear it so much now, now we spend lawyer money trying to shut down the people who are stealing it from us, but eight years ago when we first started using that name, we got a lot of criticism about how gross it was, it wasn’t really a face life, [00:37:00] but of course it is a face lift, in some ways more true than a surgical face lift, in that we are lifting the skin away from the skull and recreating that younger, full shape.
Of course, I’m all for surgery, I have great, we have amazing plastic surgeons at our groups. I want to make sure I say, someone goes through a windshield, we can put their face back together, that’s wizardry. We have amazing plastic surgeons. But there is this war for what [00:37:30] a word means, right? Like what does vas rejuvenation mean, some people want that to mean just surgery, and some people don’t want us to use it at all. There was this war, they thought the vampire name was gross and they thought we didn’t deserve to be able to use the face lift name, so you had enough courage to come on early and I’m grateful for that.
Let me see who else is on the call. Here’s a question from Rob Hamilton. If you don’t mind, [00:38:00] I gonna unmute you, too, Rob and see hold on a second and see if you can just ask the question. Go for it. Can you hear me, Rob? Are you there? There you are, now we can hear you. Go ahead and ask your question.
Speaker 3: Did you want some coffee or anything?
Charles Runels: Are [00:38:30] you there?
Speaker 4: Is there any way around here to get a bowl of soup?
Charles Runels: Okay, I’m just going to mute him. He must not be able to hear me. Okay here’s his question. He says I’ve done two hair restorations procedures and the patient said the intradermal injections both the vitamin and the PRP were very painful. I tried scalp blocks but didn’t have much success. We had tried putting the cream on also, again still painful. [00:39:00] Any hint, tips, experience for better pain control during this procedure. Sorry, I may not be able to stay on the line, okay.
So yes, I get that a lot that the hair is painful and so I’ve seen many ways, at least half a dozen ways to block the scalp and I’m overdue to do that. I’m just gonna promise you I will do that. I teach it in my hands on classes. [00:39:30] The method I have found works the best for me, at least in my hands and the short description would be though is I’d take 10 millimeters of 2% lidocaine and I usually just use it without epinephrin and I make little blebs just below the hair line as though I were making a line across the forehead, like you had a headband on. I do that across the front and then I do two injections in the back [00:40:00] that I’ll demonstrate on video, each of them two and a half ccs.
Section 4 of 5 [00:30:00 – 00:40:04]
Section 5 of 5 [00:40:00 – 00:50:55](NOTE: speaker names may be different in each section)
Speaker 1: And i”ll demonstrate on video each of them two and a half CC’s a piece and that gives me good pain control. That’s the first thing. And it usually gives me wonderful pain control but hardly ever perfect.
Then the second thing I do is I divide the PRP into one CC syringes with a Luer Lock. One CC syringes with a Luer Lock and I put 30 gauge half inch needles on there. The significance of that is that the 30 gauge needle doesn’t hurt much, but [00:40:30] if you put that 30 gauge half inch on a five of a 10 CC syringe, it takes forever to push the PRP out because the hydraulics all off. But if you it in a one CC syringe without a Luer Lock you just blow the needle off the end of it and you just give the person a PRP shower.
So it has to be a Luer Locked, one CC syringe and then the hydraulics are that you can push that very, very quickly. And so you can do the scalp literally [00:41:00] in about a minute or less. Where … So even if you have, say you have three out of 10 pain, if it takes you forever to do it, after you’ve done a bunch of injections, they’re not liking it. But you can get a six out 10 pain and if you can be done in 30 seconds, 45 seconds, they’ll still think it was pretty good because you’re just over before they have the time to complain much.
So those two things, the block combined with using that setup allows me go very quickly and so I owe you a good video to show [00:41:30] you how I do my block. And again, I have the great privilege, I think, to have taught these classes now for eight years and seeing how the people who come to me to learn the face, who are already making a fortune doing hair, see how they do the block. People come to me who are a very expert and every class I teach I try to learn something. So, it puts me in a very, I think … I’m just very blessed to be able to learn from you guys. So I’ll take [00:42:00] my combination best block and put a video up. But swap to the one CC syringes with a half inch 30 gauge.
Okay. So here’s another one from Dr. Newbanks. That’s a good tip. So I’m gonna let you tell them that. I’m gonna see if you can … Hopefully I can get you on here. Dr. Newbanks has been with us awhile. Let’s see if I can get you on.
[00:42:30] You there, Desmond?
Yeah. There you are. Beautiful. So give us your pearl about hair. Nice to hear from you.
Desmond: Oh. Yeah. Good to hear from you.
Well, what i do with hair, I have a little magnifier, dermatoscope, that attaches to my iPhone and so I can look under pretty high magnification of the scalp and there are areas that look full but they’re actually very wispy hair. And that helps me to be a little more precise with my injections. [00:43:00] And I combine PRP with an amnion called BioDRestore and get really good results. And the results tend to last … Oh, a year and a half.
Speaker 1: Beautiful. So you’re … Appreciate that tip. So where did you get the magnifier that’s attached to your iPhone?
Desmond: Well, it’s made by a company called Canfield. And it’s the brand is B-E-O-S H-D-2.
Speaker 1: [00:43:30] B-E-O-S H … as in hat, D as in dog, 2?
Speaker 1: Okay. I’m gonna put that in the chat box. Thank you for that top. Let’s see.
Speaker 1: B-E-O-S H-D-2. And it’s called Canfield with a C right?
Desmond: Canfield with a C is the manufacturer.
Speaker 1: Okay. Great tip. Okay.
And then, there was something else I was gonna … Oh. For your [00:44:00] amnion, I’m pretty sure the BioD people get their amnion from our new supplier so you might wanna look at the price on the website. If you go … I think I just showed you where to get to it. If you go to the Vampire Face website or member website. And then you click over to the Vampire … Look under the recent posts under Vampire Hand Lift and then you scroll down. That’s it. That’s the telogen. [inaudible 00:44:28] supplies. [00:44:30] Excuse me. Telogen, you can see it there in my little video, supplies entheogen or the amnion entheogen plus this is the amnion. And we’re getting 25 milligrams for a price that’s probably about a third … I bet it’s no more than a half of what you’re paying to the BioD. So hopefully that’ll help you.
And by the way, that price is only on our membership site. It was part of the deal I cut with them. I don’t have it out there. It’s only for our members. They just figured they [inaudible 00:45:00] [00:45:00] for it with volume because our people are, or they knew how to market and how to take care of people. So, might check it out.
But that’s a good tip. So, did you try it? Did you do the scalp without the amnion and swap over. What caused you to swap to the amnion? What happened there?
Desmond: Well, I just started using the amnion. The guys that I’m training with down in Boca Raton used the BioDRestore. And that’s why I used the BioDRestore. I started using that. [crosstalk 00:45:29]
Speaker 1: And [00:45:30] you saw a difference in your success rate?
Desmond: No. Again, it’s based on his experience. That prior to him using it, his results were not as good and were not as long lived but after the BioDRestore, there was a substantial difference, or the amnion.
Speaker 1: Beautiful.
Do you know what milligram it is that you buy? I know that the product come in …
Desmond: It comes in a one milligram vials. But these are [crosstalk 00:45:59] [inaudible 00:45:59].
Speaker 1: Oh. [00:46:00] It’s a one milligram vial?
Desmond: It’s a one milligram vial. And it’s frozen. So you gotta have a freezer that can keep it at -30 degrees.
Speaker 1: Not sure what happened. Yeah. Ours is a 25 milligram vial. So, even if … I’m not sure what happened there with your sound. Check … ‘Cause it comes as a powder and it comes reconstituted with a powder and a [00:46:30] sterile saline. And no matter what the volume is, look at the milligrams because we’re getting a 25 milligram and one CC. And we have half of that, we have 12 and a half milligrams and a half CC. And it could be that what we have is quite a bit more for a lot less to help us stay profitable.
So thank you for those. Those are good pearls.
Speaker 1: Let’s see if we have other questions.
I’m not sure what happened with our sound there, Dr. Newbanks. Hope you forgive me for that.
Desmond: [00:47:00] No worries.
Speaker 1: Okay. So, here’s one from Dr. Pickens. I’m gonna unmute you, Leslie, so you can … Oh, he fell off the call somehow. Okay.
I’m gonna unmute you, Dr. Pickens because it sounds like you might have had some things go wrong. Let’s talk. I mean, nothing serious, but let’s figure this out.
You there, Leslie?
Can you hear me?
[00:47:30] I’m not sure what happened. Can you guys here me?
So, I’m just gonna read this question. I’m not sure how we got disconnected.
Oh. Okay. So Leslie’s still there, but her sound is off.
Okay. So I’m gonna read your question, Leslie. It says, “I’ve done the ‘Vampire Breast Lift’ in patients with small breasts or long pendulous breasts. [00:48:00] You see little change. I’ve even used radioshurperapies. Anyone gotten success with patients with small breasts? If this is to [inaudible 00:48:08] aspects of the breasts with large?”
You know, that is a … That’s tricky. So, heres the thing. With the long pendulous breasts, say where it’s just almost flat and long pendulous, they … It doesn’t work as well. And I often will just, will not do it. I’ll tell them that probably they need [00:48:30] an implant, and I’m just not gonna be able to do much. When I’m talking almost flat, very long pendulous.
For the smaller breasts, I sometimes do get good results, but I have to let them know what’s going to happen. That you’re going to be perkier. So with this, they’ll be fuller, but it’s not going to be necessary cleavage that’s meeting in the center. It’s just going to be perkier like they had the bra on. And this … So this in a smaller [00:49:00] breasted woman who’s 20, may not do so much because they’re already perky. But let’s say she’s 30, and she’s breast fed her baby, then even though I’m still not going to have the breast … The cleavage meeting in the center and maybe not even enough coming towards the center to where she thinks it was a dramatic change. Because her breasts are not as perky perhaps as they were before she breastfed, she’s likely to [00:49:30] still like what I did if I tell her that’s what the goal will be and she’s, knows that up front.
And using that strategy, I do have a lot of ladies who had smaller breasts are happy, but not so much with the long pendulous breasts. So hopefully that answers that question.
So, I think maybe that’s enough. That’s 15 minutes. And I think we covered most of the questions. We did some marketing. Does anybody have anything they wanna add that’s … [00:50:00] Before we close this down because I know there’s some people on the call that are very experienced.
I hope to have some new tips. I’m spending three days and a bunch of money out here in Santa Barbara learning from the best. I’m surrounded not by doctors but by marketing people and programmers. So hopefully we’ll, I’ll have some new tips for you guys that I didn’t have even yesterday by the end of this week that I can put out there.
I continue to be honored. I don’t see anybody raising their hands. So you guys have a good day and [00:50:30] I’ll post this recording. Go check out the amnion and be sure and put up lots of stuff about Vampires this month because … Even if you’re just doing [inaudible 00:50:41] you can say, “Like the Vampire works, here’s how the [inaudible 00:50:46] works.” Use that Vampire word and you’ll be tapping into the flow. You guys have a wonderful day. Bye. Bye.
Cellular Medicine Association
Only for Members of the Cellular Medicine Association (CMA).
Edited transcript of the above video…
Hello. This is Juliann Hunter, and I’m Charles, and this is our monthly update for the Cellular Medicine Association.
New Amazing Book
Dr. Red Alinsod (one of our lead providers & the inventor of Thermi-va) edited this book and invited us to have a chapter about the O-Shot® procedure. Dr. Christrine Hamori (also one of our providers & the lead editor of the book) did a wonderful job putting together a gorgeous text…so pick it up. Even though the title reads “Genital Surgery“ textbook, it also discusses nonsurgical procedures–for example it covers ideas about radio frequency and lasers & how to combine those technologies with the O-Shot® procedure. So, I highly recommend reading through the book. Even if you don’t do genital surgery, your patients will benefit if you understand the possibilities.
Lichen Sclerosus Study
Second, since we talked last, we have a lichen sclerosus study that has came out. You want to zoom in on the blue journal. We’re really proud that our group conceived & financed the study protocol. I’m very grateful to Andrew Goldstein for pulling this off for us. That was a hundred thousand dollar project, plus extra, but it’s done. It showed positive results. Some of you guys have seen these pictures already, but you don’t have to be a pathologist to tell that these are different, right?
In the “before” you can see hyperkeratosis and subepithelial sclerosus that improves tremendously in the after photos.
We are doing a follow-up double-blind placebo controlled study.
The placebo is saline. The syringe is brought blackened so neither the doctor nor the patient can tell what’s in it.
Introducing Juliann Hunter…
That’s enough of the science. We’ll come back to science. Let’s talk about business. Juliann works here and just leads our whole building. She has an MBA from Emory, has led huge projects (50 million dollar budgets) as a project leader for Verizon–and knows what she’s doing–so I’m very proud to have her helping lead our team. I asked her to think about one THE or two things that she would like all of us to be doing to do more business.
There are two things that I would highly recommend that you do help the people who need you to find you…
- Sgn up for an Sure Start-Orientation/Marketing Appointment (click). One of those appointments gives you an hour with one of our business experts. We will walk you through the website to help you find the all of the following…
a. Videos on how to do the procedures b. Patient surveys (by text messaging) that allow you to collect data on your patients and to contribute to our research. c. Legal documents and consent forms. d. Where to buy supplies. e. Webinar videos with multiple providers discussing the nuances of the procedures. f. Blogs where you can read or post questions to the group about ideas or unusual problems. g. Videos about marketing techniques that we've tested and found to be very powerful.Most importantly, while on the call, we can give you personalized advice with marketing, with your websites, and we will answer any question that we can.
So Calendly.com/CellMed. That is free to you as part of your membership in our provider group. We have three people here with business degrees who are watching our providers, and they can see who is winning, and who is struggling, and they know the missing ingredients and will survey your marketing efforts and give you 1-3 things to do that will work to connect you with people who need what you are offering.Even if you’ve done this consult with us before now, if you’re still not scheduling at least two people a week for these procedures, then schedule another consult and we will give you the next thing to work on. I promise you this; the people that are the high producers in our group are the ones that have called us the most, and have been on the website studying the materials the most. So here you have a person (Juliann) with an MBA from Emoryand 2 other poeple with business degrees and experience with our group who looking at all of our stuff and all of your stuff and offer you free advice about what you can do to make your practice work better. So take advantage of that.Now, the next thing …
The other thing is auto-responders. We talk a lot about reaching out to your patients, and offering them help and advice. We talk a lot about reaching out to your patients, and giving them free advice to help them with longevity or their health, energy, whatever you choose to tell them about. But, there’s a difference between sending emails to someone, and having a whole auto-responder and sequences to add your patients to, and to add prospective patients to. One of the things that Dr. Runels has done an incredible job developing is specifically for the O-Shot right now– (1) 22 email auto-responders & (2) an O-Shot® webpage. We will help you set up how to get that information when somebody gets to your web page, where to go to find out about that is…http://oshot.respond.ontraport.net/free-marketingWhen you sign up for that, you will receive the auto-responders. You will receive a web page that has been designed about the O-Shot, and in addition to our support, you will also get support from a company called Ontraport that can help you set everything up from the web page, to getting information from people who land onto your website, and what you can do with that.
Everyone I know who makes 10 million or more on the internet uses auto-responders. Now we teach this in detail at our workshops. How to do it, how to write the emails, and part of the reason that people come to our hands-on workshops more than one time is that we teach in detail how to do this. But so many people wanted it done for them, we are offering this for $1 (The $1 charge to your credit care is so we can confirm it’s really you). To use the autoresponders, you use the system that’s built to make it operate.
So you may want to move your list from whatever you use now to send emails over to this system, since we give this as a freebie to you for being in our group but it takes the Ontraport system to make it run.
Ontraport can help you with moving everything onto the Ontraport system, and then there’s another big difference between Ontraport and the other auto-responders that are out there, and that is it will allow you to send postcards (they print & mail what you make on your computer), which we found to be really important because we get so much email these days that when people get postcard they have actually have something that they can touch, that that really makes an impact.
Charles Runels: Yep, that’s a good point. Not only postcards, but it allows you to automatically assign tasks to your staff at certain intervals based on what patients do.Okay, enough about business building strategies, other things that are happening with our group….
- I just spoke at THE Aesthetics Show (just a short lecture about sexual dysfunction) and I was very proud to see several members of our group leading the meeting. On stage was Dr. Tess (“America’s Favorite Dermatologist”) who was judging, and in the competition we had Dr. Red Alinsod, Dr. Otto Placik, and Dr. Oscar Aguirre (all leaders in our group).
Last year, Dr. Alex Bader (who also teaches for us over in Greece and London) won one of those competitions. We are honored to have some true wizards in our group, so I just wanted to congratulate our amazing members who were there. If you want to do some hands-on training, I highly, highly, highly encourage you check out their classes. Especially, if you’re a gynecologist, urologist/surgeon, we need more people who understand how to do this these surgeries.
Here’s an example from another one our teachers (Dr. Kathleen Posey)…
So taking this phimosis where you cannot even pull the clitoral hood back and doing an in-office procedure where you can free that up, and now you have a normal vagina that looks and feels normal to the woman when she enjoys relations with her husband (patient was already on steroid creams, followed by a dermatologist, and had gone YEARS without sexual intercourse with her husband). Dr. Kathleen Posey teaches a class about how to treat lichen for gynecologists and urologists, and plastic surgeons. Also, everyone else I just mentioned. Dr. Oscar Aguirre out of Denver, Red Alinsod out of Southern California, and Otto Placik up in the Chicago area, all those guys do really amazing classes. Dr. Alex Bader does a class over in London teaching the nuances of how to do that not only for pathology like that, but for cosmetic purposes as well, which also has been proven to help sexual function.
So it’s not just about looking pretty. If you have a labia minora that’s in the way, coming out of your bathing suit, getting in the way when you’re having sex, it’s been proven it actually improves sex when that is corrected, so how we recommend those courses for the gynecologists in our group.
Some of our teachers focus on the face, some on the genitalia of women, some on men’s sexual dysfunction, some on correcting the complications of lichen sclerosus.
By the way, if you already have the skill set and you are willing to help treat these poor ladies that are suffering with lichen (either surgically or otherwise), please send an email to our support email address, and we will put a little icon by your name because these ladies that are suffering are calling our providers that are willing to take care of them.
Okay. Next thing…
- We have a double-blind, placebo-controlled study going on now that we just launched. We’re using saline for the placebo. We’re paying Dr. Andrew Goldstein to conduct the study. I can almost promise you that this WILL be published. We need 40 participants. 20 placebo, 20 treated (all treated for free, including blood testing).When we (hopefully) show benefit then the 20 that got the placebo will be offered the real thing for free. so please send us some people to participate, and post it to your blogs and your Facebook page because your patients, even if you live across the sea in New Zealand, you may have patients who know people in the Washington DC area, so help us get the word out…
Here’s where to send people when you ask them to let people know about the study…
- Just one other thing here. Here’s the number to call our office…
Please make use of this. If you are not getting at least two patients a week who needs what you’re offering with these PRP procedures , then there’s some missing ingredient in your marketing-chili recipe. We can look at the recipe and tall you what’s missing, so make use of us. Some of our people still don’t even have their pictures posted. You just won’t get as many calls as the providers who do. Little simple things like that that don’t cost money, but will make your practice much more successful.Okay, so I’m just telling you there’s another procedure that’s come out. We’re going to call it the Vampire Wing Lift™. It is coming, it’s going to be amazing, and so you will here more about that in an email in the next two or three days.
So, anything else Juliann?
That’s it. Just sign up for those Calendly’s, please.
Yes, Calendly. What we have found, we have very low drop-out rates, less than 10% in a year, but what we have found in every case, every person who has dropped out never did our free marketing, “Sure Start”, so make use of it.
Sure Start Free Marketing Consults<—
All right. Thank you.
52 South Section St.
Fairhope, AL 36532