Double-Blind, Placebo-Controlled Study Demonstrates that the P-Shot® Works for Erectile Dysfunction

It’s True! The P-Shot® Helps Men with Erectile Dysfunction

News provided by
Cellular Medicine Association
June 14, 2021
FAIRHOPE, AL, June 14, 2021 /PRNewswire/ — Sixty men volunteered to have their penis injected with their own blood by eight urologists from Aristotle University in Greece; the results—a double-blind, randomized, placebo-controlled clinical trial published in the May 2021 issue of the Journal of Sexual Medicine—showed that “Platelet-Rich Plasma (PRP) Improves Erectile Function.” More than two-thirds of the men who had their penis injected were pleased with the improvement in their erection and there were zero complications from the procedure. During the study, the sixty men who participated were not allowed to use any other treatments to improve erections.

Dr. Charles Runels (the inventor of the procedure, which is called the Priapus Shot® or P-Shot®) said, “It’s been a long decade with much resistance, but I’m hoping this new study helps more physicians recognize the potential benefits of the P-Shot® procedure.” 

On September 12, 2010, Dr. Charles Runels registered his Priapus Shot® (P-Shot®) with the US Patent and Trademark office—announcing that he had found a way to inject platelet rich plasma into the penis to improve the health and function. Since then, multiple studies have been conducted and have shown benefit; but, adoption by urologists has been slow. 

“We needed this study.

We needed this study. I’m a community physician with a small office who just happened to be blessed with the discovery of this therapy more than a decade ago. We have amazing and brilliant providers in multiple universities; but, even they have trouble securing financing for research since the procedure involves the patient’s own blood—there’s no drug, and so there’s no pharmaceutical company to finance the research. If this were a drug, you would see commercials about it on every televised football game—it’s that effective. Until now, surgery and prescription medicines have been the first choice of most urologists and family practitioners; with this procedure, there is not a drug to buy or sell and there’s no surgery. I’m grateful these brilliant physicians from Greece have strengthened the evidence that the P-Shot® should be considered along with the current therapies. Nothing goes away, but this important option should no longer be ignored” said Dr. Runels.

Dr. Runels also invented the Vampire Facelift® in 2010 and used his observations from that procedure to design the P-Shot® procedure and the O-Shot® procedure—all of which use PRP: which is known to improve the circulation, nerve conduction, and collagen production and so to improve the health of tissue in over thirteen thousand research papers in multiple tissue types.

“Though these brilliant researchers helped prove the concept of the P-Shot®, their research protocol had to be kept simple to improve the clarity of the conclusions; their published protocol does not include all of the components of the P-Shot® procedure,” said Dr. Runels

All of those physicians and nurse practitioners who are licensed to perform the P-Shot® procedure (in 55 countries) will be found at PriapusShot.com. Providers not listed there may be performing an inferior procedure or doing the procedure illegally. Dr. Runels and his colleagues of the Cellular Medicine Association, conduct and consult regarding research in the areas of esthetics, erectile dysfunction, urinary incontinence, orgasmic dysfunction, lichen sclerosus, & the treatment of scaring using blood-derived growth factors. 

“Please beware, serious problems have happened when patients have undergone what was advertised as one of our procedures (Vampire Facelift®, Vampire Facial®, O-Shot®, or P-Shot®) from unlicensed providers who did not follow the protocols of the CMA,” said Dr. Runels.

Contact:
Charles Runels, MD
Medical Director
Cellular Medicine Association
888-920-5311 phone
251-650-1251 fax
DrRunels@Runels.com
https://PraipusShot.com
https://CellularMedicineAssociation.org
SOURCE Cellular Medicine Association 

A Double-Blind, Placebo-Controlled study shows that the P-Shot® (Priapus Shot®) works for ED.
More research about the Priapus Shot® procedure<—
Find the P-Shot® provider nearest you (50 plus countries)<–
Apply for training to become a licensed P-Shot® provider<–

Legal Notice

After trying to resolve quietly, the Cellular Medicine Association was forced send the following letter:

–>Read Warning Letter (Click)<—–

More about current FDA guidelines and PRP<—

Charles Runels, MD

Cellular Medicine Association
1-888-920-5311

Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout

Topics Discussed Include the Following…

*Penile Rehabilitation post prostate surgery
*Shock Wave Therapy
*
Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout
*Peyronie’s disease treatments
*Radiofrequency
*Priapus Shot® (P-Shot®)
*Safety in the Office with COVID
*O-Shot® for Urinary Incontinence

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

Transcript

Charles:

About two years ago, I was teaching a workshop at my class and a urologist was there, who was head of the department at a prominent hospital/university. And in the process of talking about some of the procedures and some of the ideas in the group, I mentioned Dr. George Ibrahim. And when I did, the response I got was like I was talking about, I don’t know, St. Peter or [inaudible 00:00:51] or something.

Charles:

So, our guest today, Dr. Ibrahim, has a lot of respect. He was teaching urologist at Duke for quite a time and then opened a private practice. Like all of us, he was in the fire, paid his dues, and then none of us want to stop. And so he’s built up multiple located … I think he has two locations now where he does our procedures and continues to teach for us. But it’s really been interesting to learn from him because the combination of his ideas about urology and combined with his ideas about our procedures have been unique and helpful. So I think without any further delay, let me just pull him onto the call so he can answer some of the questions that have come up and talk about some of the ideas that have occurred to him during his work. So let me just get him on the call right now.

Dr. Ibrahim:

Dr. George Ibrahim

Fine. Hello Charles.

Charles:

There you are. Yes. Thank you again for being on our call today. Lots of people are on the call. I put out a sort of a teaser, let people know that you would be here. So, quite a crowd today. And a backlog of questions from people about things that I want your opinion about. Just so you guys know, Dr. Ibrahim and I spoke briefly yesterday, but most of the stuff that I’ll be asking, I’ll be as curious as anybody about what his thinking is. We haven’t had an in-depth discussion for a while. So, why don’t we just start off with the list I have here of topics that occurred to you that might be helpful. George teaches for us. And so he’s alert to the problems and the challenges that come when you introduce these procedures to your practice as well as to the science and the discussion that’s going on in the medical literature and among our group.

Charles:

So, I have this list of potential topics. You can just start wherever you want, and I know everyone will be interested in your ideas. I can list them all for you if you want. The first thing I had here was dyspareunia, if you want to start with that one, because it’s such a hard problem. To me, that’s the worst of the sexual dysfunctions for women because they can fake arousal or even accommodate lovingly without a high sex drive. And an orgasm sometimes is not necessary. Women with pain will start to avoid their lovers. So let’s start with that one since that’s such a tough one

Dyspareunia

Dr. Ibrahim:

Well, Charles, thank you too so much for your introduction. I do appreciate you give me a chance to be here with you. This is an honor, and I hope we can make everybody’s time worthwhile. So to get straight to your topic, I really think that without addressing a female’s hormonal balance at that time of her age, you’re not going to make much headway. Borrowing a history of breast cancer that’s ER positive, there’s really no reason to not optimize the female’s hormones, everything from the lubrication that it brings to bring it back, the vaginal walls and helping with the tissue paper aspect that you see once a woman goes through menopause. These are the kinds of things that I really think, unless you’re going to be able to do that, you’re going to have a hard time.

Dr. Ibrahim:

I do think that the O-Shot can help, but unless she’s got some [ } on board, and that can be done topically and regionally. It doesn’t have to be done systemically, but I think that’s one of the first thing that at least that’s what I always tell one of these kinds of women that have suffered from this problem.

Charles:

Yeah. I like to stress to people that so far in spite of several years of campaigning for it, I like to stress to people that it’s really all we’re doing, these [PRP/cellular] procedures, is just making that local tissue healthier, but there’s so many other parts involved in the sexual response from the spinal cord, to the psychology of our thoughts, to the hormonal [inaudible 00:05:24] you that has to do. Without hormones, we can’t even make collagen or have blood flow. Hormones make our heart pump. So, there’s this system, and I’ve been campaigning that we talk in systems analysis the way we talk about a neurological system and a cardiovascular system. And the reproductive system is not the same as the orgasm system or the sexual response system. So, stressing that to our patients so we’re not over promising them a magic shot, but helping them, although it can be like magic sometimes, but helping them understand there’s this whole system we have to think about.

Dr. Ibrahim:

Absolutely. And with testosterone going to zero in almost every one of the menopausal women I see are almost undetectable. There’s no way that there’s going to be any desire or lost. And while you might be able to help with the lubrication, without that mental stimulation or desire, it’s not going to be a fun experience. It might not be painful anymore, but it’s hardly enjoyable from what I hear from my patients.

Charles:

So talk to us about how you think about, so you first start with optimizing their hormonal status. And there’s so many … The diagnosis, I’m almost regretting now starting with this because the diagnosis of dyspareunia is so complicated. But, maybe a fairly quick overview of how you think about that diagnosis, everything from dryness with breast cancer to surgical problems, so that maybe at least give an outline for the people on the call.

Dr. Ibrahim:

I think that the biggest part of the pain that a woman [inaudible 00:07:06] has and comes to fear when it comes to sex after menopause, is that the vaginal epithelium has become so atrophic. And without a nice beefy, robust, lubricated, thicker vaginal wall, so the vaginal walls, any kind of sex is going to be painful. And that’s where I’m going with it all.

Charles:

Okay. So when you do your procedure with the O-Shot, because you know you can have the dryness for breast cancer or you can have a pelvic floor tenderness, you can have an episiotomy that’s tearing, not mentioning the things like ovarian cyst and uterine fibroids, but the things that we can address with an O-Shot, can you talk how you might vary the how you do the procedure with a woman who has tenderness that it’s in a particular spot versus just overall dyspareunia from say dryness?

Dr. Ibrahim:

What I’ll typically do, if she is in menopause and she has been away from any kind of estrogen production for a few years, I’ll try to see if she’s against doing systemic hormones to see if she would do around about three to four weeks of topical extra dial. A lot of folks like to use a combination of estriol and estradial. I think estradiol is much more powerful, but I try to get them to do about three to four weeks prior to doing an O-Shot, telling them that it’s going to make, the O-Shot’s ability to repair tissue and strength the things and all the magic that the O-Shot does, a lot more [inaudible 00:08:49] better blood flow in the face of the O-Shot if she can do some estrogen for a while ahead of time. So I’ll try to get you to do that for about a month. And then I’ll go ahead and do the O-Shot.

Dr. Ibrahim:

And oftentimes, especially in women that have been in menopause without being on estrogen, I will oftentimes warn them ahead of time, “Look, we’re going to see some results from one. It might be phenomenal, but don’t hold off on doing a second one within two to three months after the first one to augment the effect of the first one.” Especially, again, if she’s not been doing estrogen.

Charles:

Okay. So, I know you have an upcoming class and I want to put this in the chat box so you guys will have access to it before I forget to do this. And Dr. Ibrahim, as I mentioned, was a highly respected teacher of surgical procedures. And I’ve seen him teach there in his office. And he’s patient and articulate and cordial and inspiring. So I highly recommend his class if you’re looking for some hands-on work. And he’s squeezed it into one day by leaving out the aesthetics part and focusing really heavily on the sexual medicine for both men and women.

Charles:

I know this, in your course, you’ll talk some about radio-frequency and laser technologies. And I actually got a question today about Emsella. Maybe just expand upon your ideas about things to do along with when it comes to the machines. Because I know people are either have them or contemplating them. So radio-frequency, laser and magnets, could you talk about how you work those into your protocols?

Dr. Ibrahim:

Absolutely. And before I do that, I’m going to put the plug in for the workshop. It’s going to be March the fourth. We’ll just squeeze everything into one day. Fortunately, I’ve had COVID and my first vaccine, so has my physician’s assistant, and the majority of my staff. But, we’re going to do what we have to do. That all being said, I do use enhancement. Patients are given the option. Some patients only want to get another shot or a Priapus Shot®. Some have heard about some of these other methods. I’m not here to do a commercial for any particular device.

Combining Shock Wave with the P-Shot® Procedure (timing)

Dr. Ibrahim:

I chose a laser over radio-frequency but I’ve seen both of them were great. I just chose not to have two devices that accomplish basically the same thing. So, I use a laser, but I’ve no … It’s done essentially the exact same way as radio frequency. And I use that often when I’m doing my O-Shots. And then with men, even if they don’t want to sign up for an acoustic wave treatment series, are pretty much always we’ll do some acoustic wave treatment just prior to injecting them for their P-Shot because I think that the [inaudible 00:12:04] trauma that we’re producing and increasing the blood flow from that acoustic wave treatment absolutely helps keep the PRP in place and excite the growth factors to do the jobs that we’re hoping that they’re going to do.

Dr. Ibrahim:

That all being said, my staff loves doing these workshops. And we’ve missed it for all the travel restrictions this past year. And so we’re itching to get back in it because they have fun doing it. They love seeing me teach because I know that’s where I used to do it. You may say I’m always my most excited and happiest when I get to teach. And so it’s always a fun event.

Charles:

Beautiful. Yeah. So if you guys are interested in that, click the link now because the link goes away when the webinar’s over and then you’ll have that page open. So, you will sometimes do a shockwave therapy at least briefly, even if they haven’t asked for it, just prior to a P-Shot. Let’s say that they go for it and they say, “Money’s not an object, I live down the street, Tom’s not a problem,” what would be your Cadillac treatment for a man with, let’s start with Peyronie’s disease, what would be your protocol?

Charles:

Because here’s the thing, I get the questions all the time. We’re still working on getting enough research out there. We have some. People act like we have none, sometimes our critics. We actually have a pretty good list of papers now over the past five or 10 years, talking about our stuff. I’ll just give you the list for the Priapus Shot. And it’s not a thousand papers, but that’s a pretty impressive, I don’t know, it’s probably 20 papers out there talking about PRP in the penis now. But there isn’t this goal [inaudible 00:13:52]. It’s like if you run a 100 yard dash, you know when the race is over. But the effort to convince our colleagues that PRP is a viable option where it becomes standard of care for every urologist and every family practitioners treating Peyronie’s erectile dysfunction, there’s no discreet line that’s, okay, now we all start to do this.

Combination Therapies for Peyronie’s Disease

Charles:

So, even more so if you start combining, okay, what’s the best algorithm if you’re going to combine it with shockwave. And there isn’t no published study that says, “This is the best, and this is what the recipe should be.” So when I get those questions, I’m always curious to what your protocol would be for someone with unlimited funds, unlimited time, how would you treat Peyronie’s?

Dr. Ibrahim:

That’s a great question. And I’m thrilled that you told people we all have different recipes for cooking a pound cake, basically. Because the science isn’t out there and I’ll give you my rationale reasoning for doing it. They’re offered the choice off easily. Again, just the Priapus Shot® or the acoustic wave treatment combined with a Priapus Shot®, when they choose the combination, which the vast majority do. Part of that, the reason is we make it much more attractive for them to do it as a package financially. But more importantly, I know that we’re going to see a better end result, have a happier patient. And I’ve said this, especially in my aesthetics practice, nobody is ever upset by spending more than they plan to spend if they get a better result than they thought they were going to get.

Dr. Ibrahim:

And so with that in mind, and just assuming they’re planning on doing both acoustic wave and the Priapus Shot® at the same time, for Peyronie’s, right off the bat, tell them this is not going to be a one and done situation. “Peyronie’s, Mr. Jones, that’s going to be something that we’re looking at. I want you to be scheduled for at least two of the Priapus Shot®.” Again, there’s the financial incentive that it’s not two times one cost. And I will typically start by doing the acoustic wave treatment. And I identified the plaque for our medical assistants who are the ones who deliver the acoustic wave treatments. And they’ve been very, very well-trained because my grasp of the penile anatomy and everything. But I have them concentrate a lot of the acoustic energy on the plaque itself.

Dr. Ibrahim:

And typically, we’ll have them do three acoustic wave treatments in a row. Mostly depending on how far away they live, typically a week apart. And when they come back to their third or their fourth acoustic wave treatment, right after they’ve had the acoustic wave treatment, I’ll do the Priapus Shot®. And just if people are taking notes, men who have acoustic wave treatments do not need to be numbed, but if I’m going to be doing a Priapus Shot®, I’ll go ahead and place my penile block before they do the acoustic wave for one reason, impatient. This guarantees that the guy sat around for at least 20 minutes letting the block sink. Number two, if I missed one of the nerves, they’re able to tell the medical assistant, “My right side of my penis is completely numb but I can still feel it on the left, and she lets me know when I come back in there and augment it.”

Dr. Ibrahim:

So I’ll do the first Priapus Shot® in the middle of the acoustic wave treatment. And then I’ll do the last or the second Priapus Shot® following the same day of the final acoustic wave treatment and then see how they go from there, telling them ahead of time, we’re probably going to have to do some kind of maintenance afterwards, meaning maybe one acoustic wave treatment a month and maybe a Priapus Shot® once or twice a year, depending on how they are or what kind of results that they get from their Peyronie’s. And one more thing before I go much further. This is one of the times where I’m very insistent on the penile pump or the vacuum erection device.

Charles:

[crosstalk 00:18:10]. That was my question.

Penis Pump Tips

Dr. Ibrahim:

Yes. Okay. We have templates that every patient gets, and it has a video and it has their instructions because they’re going to forget 90% of what you tell them in the office. But the first line of the penile pump instruction is, this is frustrating. You’re going to feel like you need a third hand to hold down your scrotum while you hold the cylinder and the other hand holds the pump. You’re going to figure it out. But I always try to teach them how to use the pump. At the initial conversation, set the time that they show up for their [inaudible 00:18:46] wave treatment and a P-Shot, they have already used the pump. The last thing I want them to do is to go home after a Priapus Shot®, I’m not going to let them do it while they’re still numb. So then the next day they try to do it and if it’s the first time they’ve done it, they’re going to be a little sore. And so it’s much better to teach the guy how to use the pump and become proficient in it before you start your other treatments.

Charles:

Let me just jump in with a couple of amens here. First of all, I want those of you who haven’t seen this, I want you to see that there is a study from the British Journal of Urology that’s been out now for a decade that shows that people who had scheduled surgery for Peyronie’s disease, 51% of them canceled it with a pump alone. And so you’ve got some science to back that up, but there is some frustration with the pump. And George is the first that I’ve heard come up with a great idea that’s like a lot of great ideas, simple after someone thinks of it, is that oftentimes the complaints people have as side effects from the Priapus Shot, they’re really blaming the side effects of the Priapus Shot on their misunderstanding of the pump. So having them do that for a week or two or some amount of time before they get the shot helps them sort that out and less likely to think that the procedure went wrong. And that’s how you’ve done it for a while, right?

Dr. Ibrahim:

Absolutely. And ever since we started doing this way, the number of callbacks, I don’t like using the word complaints, concerns has dropped dramatically. Because there’s rarely a concern after a Priapus Shot®, but the pump, if they don’t use it correctly, they over … I literally take a black sharpie and mark out a good portion of the dial and say, “There’s no reason to ever go past this line.” You don’t even have to go all the way to this line, but don’t ever go pass it because some guys would think, “Well, if one’s better, then four must be even much better.” And they would overpump and then it would not be good.

Charles:

Yep. So, another, Dr. Ibrahim, on the call. I’m going to unmute him. He has a question. Actually, I’ve got a pretty good line of questions here. So, let me see, where do you get … Here we go. Dr. Ibrahim, you’re unmuted. If you want to go ahead and just ask your question. I can read it if you don’t have your mic on.

Dr. Ibrahim:

Okay. The only questions I see are links. So I don’t know what kind of question [inaudible 00:21:41].

Charles:

Well, I can read it to you. I’ll just read it out. It looks like maybe his mic is not working. He just wants to know the ideal candidate for the P-Shot, what medicines are you giving after the shot like you putting on daily Cialis or something, any over-the-counter things you’re doing? I think that’s it. So medicines afterward, over-the-counter things, and what’s your ideal candidate for the procedure?

Dr. Ibrahim:

I don’t mean this flippantly, but I think all of us, we all know if you start with a really good canvas, you’re going to be able to get a nice painting. The ideal candidate is the guy who barely needs half [inaudible 00:22:21], I’m assuming, the P-Shot. Somebody who’s got great vasculature, good blood flow, great neurologic issues going on, they’re not smoking, they’re not overweight. But that’s not reality really, but that’s the ideal candidate, is the one that he’s not up to the performance he was at 22 but he’s still doing a good job. That’s the kind of guy I love seeing walk in the door because that’s going to be the home run.

Dr. Ibrahim:

The much older guy, the 78, six, year old man with history of renal problems, terrible Batchelor disease, diabetes, [inaudible 00:23:01] and all that. As far as over-the-counter stuff, and that is not what I give them, it’s what I tell them not to do. We have another handout telling them no [inaudible 00:23:15] and we list as many as we can because people don’t know that Excedrin is aspirin. And telling them, none of those for a week ahead of time. And for at least a week, if not more, after we do the procedure.

Dr. Ibrahim:

As far as a low dose daily Cialis … Now that the PD5 drugs are generic basically, it’s a lot easier to tell somebody to do it. I typically ask them right off the bat, have they ever tried one of the other or any of them? And a good many will say, “Yeah, I tried Viagra and I couldn’t stand the headache, but Cialis tended to not work as well, but I didn’t have the … I was [inaudible 00:24:02],” or vice versa. And I will write for some [trockies 00:24:08] just because that’s what I got used to back when these drugs were not completely generic and you couldn’t really write for pill form and get away with it. So I do have trockies that have either and/or Cialis or sildenafil in them, that I will tell them, “This could help you with everything that’s going on here.” And the biggest part of that is helping to increase blood flow. And I do tell them, especially in the beginning, it’s not a homework assignment they have to do, or they can tell their wives, “Yeah, it’s a homework [inaudible 00:24:40].” They must do but I wanted to have as many erections as possible after a Priapus Shot® as they can have to stimulate the blood flow.

Charles:

Yeah. That’s my aftercare instructions too, go home and have sex. Let me just quickly rattle off what I tell people the easy and hard cases and you expand on it, correct it, a different opinion, whatever. This is not a place for everybody just to try to agree. We’re swapping ideas. I tell people, “Avoid the person that a thousand or a million times zero is still zero.” So I tell people, “Avoid treating or at least make it a small percentage of your treatment, so you don’t get to discourage, the person who can they do Viagra or they do TriMix and just nothing happens. They never get in the morning erection, they’ve had diabetes for 20 years because they probably have vascular disease all the way, iliacs to the heart, aorta, whatever. So, and all we’re doing is treating the penis.

Who NOT to Treat with the Priapus Shot® Procedure

Charles:

Although I have heard people say they get great results with some of these patients, keep them to a minimum so you don’t get discouraged. And if that’s your first three patients with a P-Shot, you’re going to be discouraged. I try to avoid the person whose main goal in life is to grow their penis to some significant amount more than what GOD gave them, because it’s hard to make that person happy. I want the person who has Peyronie’s … The thing is our easy list is still everybody else’s hard list. I want the person who has Peyronie’s because I have a high success rate. I want the guy who had prostate surgery, who’s now been dismissed by the surgeon. Here’s where I really want you to help refine my ideas or correct them or expand them.

Charles:

I want the guy who’s had prostate surgery, who had erections before the surgery, who’s now been dismissed by the surgeon and he’s not happy with what’s going on. And then add in the P-Shot to the usual penile rehabilitation of a pump and daily Cialis. And I want the guy who’s got an erection, but it ain’t what they used to be, but he’s got something. He takes Viagra. He takes TriMix or he’s trying to avoid getting started on it. And then with that person, I’m going to be able to maybe cut the dose in half. He’s okay if his penis gets a little bigger, but it’s not his main primary goal in life. Expand on that, especially the penile rehabilitation, where would you correct me or expand upon what I just said?

Dr. Ibrahim:

[inaudible 00:27:12] I’m going to start with the first thing you said about … The example I used with my staff, and not necessarily in front of the patient, but they get the idea of why I don’t take that patient home. The patient that walks in and they’re so excited to see me, “I’ve heard so much about you Dr. Ibrahim, nobody’s ever been able to help me with this. I’ve been to so many different dah, dah, dah, and nothing’s ever worked.” And I’m thinking to myself, “And you just met the next doctor that’s probably not going to work [inaudible 00:27:39].” And I’ll listen, but nine times out of 10, it might be somebody I choose not to take or I start from the very beginning with all the, I can give you no guarantees, dah, dah, dah, kind of deal.

Dr. Ibrahim:

The thing about size, I do feel that there’s too many folks that, I don’t want to say members of our club, but I’ve seen too many other providers that offer the Priapus Shot®. And the biggest thing on their website is how we’re going to magically increase the size of your penis instantly. And I let patients know when they’re coming to see me, I go, “You’ll notice I don’t make any mention on my website about increase in size whatsoever.” I go, “We might see an increase in flaccid size. We both know that there can be an increase in both erection and flaccid sizes, but I never use that, is, “That’s why I’m glad you came to see me. I want to help you gain more size.” [crosstalk 00:28:46] If it happens, I tell him, “We’re both going to be excited, but that’s not how I’m going to measure your success. We’re going to the prostate surgery.”

The P-Shot® after Prostate Surgery

Dr. Ibrahim:

Absolutely. I was a big prostate cancer urologist, but that was my forte. And I didn’t do it at the time. But if I was dropped back where I was teaching prostatectomies, men would go home with a penile pump for no other reason, to continue to get more blood flow because they’ll stop having those nocturnal erections a lot of times because of the damage to the nerves. Even when the nerves are spared, it’s going to take some time for them to fully recover. And a lot of times they’ll never recover because as I was taught way back when, when we didn’t do many nerve sparing, that the nerves are part of the prosthetic capsule and nerve sparing is cancer sparing.

Dr. Ibrahim:

So, today, especially with the robot, many more men are left with their neurological function intact. My biggest question I ask them at the beginning is, how has it been since your surgery? And if it’s anything less than six months, I go, “Okay, well, what I’m going to do for you is not going to hurt anything, but you might want to wait and see how you are at six months because you might get all your recovery back.” But the question is, do you get any kind of blood flow when aroused? And if they’re like, “Yeah, but it’s just [inaudible 00:30:19]. It’s not hard enough.” I go, “Okay. All right, good. I can work with that.”

Dr. Ibrahim:

But if the answer is nothing, then I tell them, “Okay, well, I’m going to be able to help you. There’s no question.” And by that, I’m not telling them yet because they don’t want to hear about injections, but I’m thinking in my head, “All right, I’ve always got TriMix in my bag.” But if the [pitch knob 00:30:40] doesn’t work or depending on what other kinds of [inaudible 00:30:46] they might have going on, I might just say, “Let’s just help you out and get right down to the business. And let me show you how to do these injections.”

Charles:

Yep. Okay. All right. Let’s see. My thing’s blowing up with questions here. I’m just going to look. Let’s see if Sarah’s microphone will work. She’s got three or four questions. If not, I can read the questions to you. Sarah, are you there? Okay. All right. Let me just read her questions. So do you have the patient pump the same day as the shot or have them wait until the next day?

Sarah:

Hey, [inaudible 00:31:25], can you hear me now?

Charles:

Yeah. Go for it.

Sarah:

Great. So, one is, how much time-

Charles:

Where are you Sarah? Just got a hell of a snow a little bit.

Sarah:

I’m in Denver. And Dr. Ibrahim and I were in a shockwave treatment or shockwave treatment together. I don’t know if you remember Dr. Ibrahim. Sat next to you. Anywho, my question was, when you do the P-Shots in the middle of your shockwave therapy, how much time after the P-Shot before resuming shockwave treatments. It seems like the protocol has changed over the years.

Dr. Ibrahim:

And I do remember that workshop. So, nice to hear from you again.

Sarah:

[inaudible 00:32:11].

Dr. Ibrahim:

So I heard a couple of different questions. One was, sounded like, when do we resume pumping after the P-Shot and then what was the one about … What did you say about the GAINSWave [inaudible 00:32:24]?

Sarah:

Do you have them take any time off after your first P-Shot prior to resuming your shockwave treatments?

Dr. Ibrahim:

Okay, good. I’m glad you asked that. I don’t. So if they’re set up for their acoustic wave every week and I do their acoustic wave treatment on the Wednesday that they’re coming in normally and I do their Priapus Shot® that same Wednesday that they’re scheduled to get both of them, the following Wednesday, a week later, they go ahead and they get their acoustic wave treatment. If it was two days earlier-

Sarah:

Okay. Thank you. [crosstalk 00:33:02] the function of the P-Shot to have that trauma, that soon after huh?

Dr. Ibrahim:

Well, typically because I’m doing the first of the Priapus Shots during the acoustic wave series of 56. That first one, I typically would do right in the middle of the series at number three or four. And then I don’t do the final one until after their last treatment.

Sarah:

Right. Okay. And do you do your shockwave treatment first and then the P-Shot after that on that third session?

Dr. Ibrahim:

Yes. I do the acoustic wave first with my rationale being that [inaudible 00:33:45] what trauma that we might be causing helps the Priapus Shot and its growth factors stay around the area and focus on the parts of the penis that we want to rehab.

Sarah:

Okay. Completely agree. In that same training that we went to in Florida for GAINSWave, at that time, they were saying, wait four to six weeks after that first P-Shot before resuming treatment. But, you don’t think that’s necessary before resuming shockwave treatment.

Dr. Ibrahim:

Correct. And I don’t have any literature to support what I’m saying. And I can’t imagine they’ve got any literature.

Sarah:

I don’t think they do [crosstalk 00:34:26].

Dr. Ibrahim:

I know that the results that I’ve had doing it the way that I described have been fantastic. And have I done hundreds of these doing the protocol that they showed us, I don’t know, it might’ve been just as good. But, I’m not going to mess around with what’s working for me. But, I’m an open mind. If somebody tells me that they have compared such durations and differences, I’m all ears.

Sarah:

Okay. And then regarding the second question about pumping, I [inaudible 00:35:01] Dr. Runels that you generally recommend, I think you would have them pump perhaps immediately after the P-Shot at the appointment and at that same GAINSWave treatment or training, they recommended differing pumping to the next day because of the potential of having some bleeding and that traumatizing the patient. What is your protocol, Dr. Ibrahim?

Dr. Ibrahim:

Okay. So when I learned it, when I was at Fairhope, we were pumping immediately afterwards. I’m doing a penile block on these guys now, so I don’t want them pumping until they’re not numb. Because, like we said, at the very beginning about the pump, one of its problems is the pump causing pain and bruising and issues. And if they’re totally numb, they don’t know what’s going on. I think, especially when I’ve done the acoustic wave prior to doing the Priapus Shot®, that there’s enough trauma now. And let’s just wait till the next day when they’re not numb to resume pumping.

Sarah:

Yeah. Interesting. I used to do the block and have completely for the last year, just continued that. I use a really good topical and the Pro-Knox and they do amazing. But, just throwing that in there.

Dr. Ibrahim:

In fact, I’d love for you to contact me and let me know the source of your topical, because as we all know, it’s not the lidocane or [inaudible 00:36:33] or benzocaine or whatever. It’s the base that makes the biggest difference in a lot of these pharmacies. That base is a closely guarded secret. I’ve got some great ones that work on the [inaudible 00:36:45] because I haven’t found a good one for the penis in your right. You might not have said it, but I’m thinking in my mind, “I’ve done thousands of penile blocks.” And the goal is to get near the nerve, but I’ve hit the nerve enough times to where I’ve caused some residual discomfort from doing the block.

Sarah:

I have too.

Dr. Ibrahim:

Yeah. Which-

Sarah:

But I actually learned the technique from the block from you from one of your videos. And yeah, I’ve gone through many derivations because I do aesthetics as well for topical numbing. And I’ve just within the last year found one that I feel like is a home run. So I’m happy to share that with you. And then my last question is, are you injecting any exosomes versus PRP in the penis?

Dr. Ibrahim:

I am. And that’s a topic that that Dr. Runels and I left off, especially, some of the agenda. I do.

Sarah:

Great. I do as well. So I’d love to chat with you offline about that.

Dr. Ibrahim:

Wait a minute, I will say this out loud. I am a huge fan. A huge fan.

Charles:

So, Sarah, just so you get an idea of what we’re thinking. There are things like the exosomes and STEM cells and things that I’m most afraid to pronounce out loud. And it has to be thought about in terms of, of course the way Dr. Ibrahim does in terms of where you are and who’s the person and what’s the powers that be is saying, and is there an IRB and all that. And so it’s the kind of thing that I like to keep those conversations less broadcast so that people don’t get the wrong idea and get in trouble by not following the same kind of guidelines that George is following. So, I think the best way to find out his ideas about that is to show up in his class. But I appreciate your questions very much. I’ve got a long list. I’m going to jump to the next person, but thank you for jumping on the call. Okay. Did I lose you?

Sarah:

Nope. Thank you so much.

How to Vary the Injection of P-Shot® When Treating Peyronie’s Disease

Charles:

All right. All right. So another, I think his mic isn’t working, but we’ve got another question here from Dr. Eric [Byman 00:39:17] who says that he would like to know how … And this is a frequent question. I’m glad you asked this Eric. How do you vary the way you’re injecting your PRP when you do the P-Shot and how you’re doing, I think you touched on briefly, how you’re doing the shockwave when you’re treating Peyronie’s or do you?

Dr. Ibrahim:

Okay. For me, yes. All right. If I was not treating a plaque specifically, I would deliver almost all the PRP along the … Yeah, I do between three to five max sticks on both sides depending on the endowment. And then a little bit in the glands. I think the glanular part of the Priapus Shot is more for sensitivity because obviously the glands does not play any role whatsoever in erections. It does get a little bit more [inaudible 00:40:20] a little bit bigger, but that’s not where the meat is. When it comes to Peyronie’s, I’m going to take maybe a third of the entire amount of PRP that I have. I’ll split what’s left after that third to do this half injections. And then I will directly inject the plaque two to three to four times, depending on its size, directly with the PRP.

Charles:

Okay. Thank you. So we have another question that I’ve never had before. A lot of these questions … By the way, I’m putting into the chat box the address of someone, let’s see, who is … Dr. Peter Metropolis just gave us the address and phone number for a pharmacy. Thank you, Peter. For someone who has a cream that he’s found to be helpful doing the Priapus Shots. So you guys might want to try that one. The question is, someone got a TriMix … Let me just see if I can unmute the person who asked this, because this is complicated. You may have follow-up questions. Okay. Dr. Lydia Dennis, let me unmute you because this is one I’ve never heard before. Dr. Dennis, there you go. You should be able to speak if your mic is turned on. If not, I can read this.

Charles:

Okay. I’ll just read the question. Six year old guy with erectile dysfunction, previously on TriMix. I’m not sure what that means. But, was he on it when he came to your office or he stopped when he came to the office, but he was previously got a P-Shot on January the seventh. And two weeks later, says the TriMix no longer works. The penile pain, no pain or bruising after the P-Shot still having spontaneous morning erections. I don’t know how to explain that. My first guess is that maybe he’s overusing the pump and he’s waking up with an erection, but his TriMix isn’t working. I don’t know. Can you think of a way to explain that one?

Dr. Ibrahim:

Okay. I pulled my TriMix out of my refrigerator and I know it was fresh. And I ask him how many units he’s doing at home. If it’s an inordinate amount, I might not start with that. But I’ll then inject it myself [crosstalk 00:43:03]. Because they say they inject and gosh knows, are they doing it right, where are they doing it, and has that TriMix been sitting out for how long, how old is it? Always, that’s part of another handout that we have, letting people know that TriMix begins to lose its power both with time and temperature. So you might’ve kept it cold but if it’s four months old, it’s not going to be nearly as potent as it was today. You opened the bottle the first time. If it lays out on the counter for three hours, same thing. It’s not going to be nearly as potent as when you pull it straight out of the refrigerator. So, before I believe that it’s not working, I’m going to try it myself. [inaudible 00:43:48]

Charles:

All right. So, I’m not sure Dr. Dennis’ mic is not working. So, hopefully that’s helpful and seems to make sense to me. When someone tells me for example that PRP cause damage, it’s like saying you suffocated on oxygen because PRP causes tissue to become healthier. So it doesn’t mean it’s not happening, it just means there’s something else going on that has to be figured out. It’s not likely the PRP has actually damaged something.

Dr. Ibrahim:

Yeah. It’s like the people who tell you they’re allergic to Benadryl or epinephrin. Okay. Well, we all know what’s happening there. You’re getting sleepy. Benadryl or epinephrin, your heart’s racing, but they’re not allergic to it. If somebody is blaming the P-Shot, well, it’s also the person that was having problems to begin with, but now you get to be the crutch and he can blame you for it rather than himself for his inability. And I’ll tell the person, “I’m doing the best I can. I know where I’m putting things. I get to teach other physicians. I’ve been doing this as urologist for forever, but I’ll be glad to give you a list of folks that do a similar procedure that I do. And they may be able to help because I don’t know if I can.” Because at the end of the day, we all know you can’t help everybody, especially if they’re looking for a reason for something not to work.

Charles:

So, I have enough left on your outline to keep us busy for many hours. I’m going to try to get through as much of it as it can. And again, I’m always grateful to pick your brain on the ratio of knowledge and experience to cordial and easygoing with you is out the roof than nobody else maybe that I’ve worked with. So I always enjoy picking your brain. All right. So next on our list is … But, if there’s something you feel like you want to jump in, go for it because I don’t want to structure it so much. You don’t have a chance to just run. We have experienced people on the call, but we also have quite a number that are new.

Charles:

So if you have any quick tips, maybe we could jump to that now. With the COVID things going on, your ability to continue to make a living, it’s really interesting. I’ll get some people that are in the group that are just prospering like crazy, more than ever, truly. And then others that are dropping out. Literally, it breaks my heart going broke and closing their office. And it just breaks my heart because think about the irony of that; a doctor closing their office because people are getting sick. That’s something wrong when that happens, but it’s happening. And so help us talk to that person. How can you continue to do business and prosper, even though people were getting sick? What an ironic question, but help us out with that.

Dr. Ibrahim:

That’s great. And this should be brought up for folks who aren’t doing some of these things. Part one, when patients start to cancel an appointment or want to reschedule because they’re worried about COVID, staff, they have been very well trained by my office manager on, “Mrs. Jones, please, this is going to be one of the safest places you can be.” First of all, everybody in the office is used to washing their hands before they see anybody. Wearing masks and gloves is part of what we do day in and day out. That’s before COVID ever hit and we had to worry about PPE. We already had it all.

Dr. Ibrahim:

Number two, you’re not going to be in a waiting room with other folks. In fact, you won’t wait at all. And you’re going to pull up into the parking lot. You’re going to give us a phone call. And then one of my staff will check them in over the phone, make sure that we have a current payment, credit card, usually. They will actually even run the credit card for the anticipated, what the visit is going to be for telling them that there might be an adjustment depending on what we end up doing up there so that they’re not going to have to sit around. Their followup is going to be scheduled either before they’re ever seen, or once they go back to their car. They’re on the phone, again, with the MA. So the contact that they’re having with us face to face …

Dr. Ibrahim:

Because there was a time in North Carolina when I was limited to, I can’t remember if it was six minutes or something that I could be in the room at one time. And patients began to love it. They would walk in. They walk straight back to the room. They’d get on the table. I’d say hello to them. This was not for brand new patients. Brand new patients is a different story, but these are people who we’ve already had a relationship with. And we just get right down to business. And I’d apologize for not being able to spend more time with them, but the new rules made it. So I had a bit of time I could be in the room.

Dr. Ibrahim:

Now things are relaxed and we can spend a lot more time, but a lot of patients began to love it. So, we continue now to check our patients in and out before they ever get either up in the office or they come in, they’ve already been checked in and then they go back to their car and we finished the checkout without them sitting in a room, without other people hearing about their business. The privacy aspect’s been a lot better. So, we’ve done very well. We had two months. It was horrible and I was worried about who’s going to … I’d have to let go. And I’m happy to say nobody was let go. The new method has been a phenomenal forced change that we’ve had to do and it’s come over very well amongst our patients.

Charles:

Thank you for that detailed explanation, because it really breaks my heart to see doctors going out of business because we have more sick people. And I’ve put up here something that makes sense, but I want people to know there have research to back up what makes sense. So here we have published. You can see this was in the January 1st issue of what you would expect. People who are stuck at home are getting depressed and there’s been multiple research papers out about that. They’re getting depressed, there’s more abuse, there’s more substance abuse and physical abuse and child abuse, but the people that are having sex are doing better.

Charles:

And I’ll put this up here because, especially in the beginning of COVID, but it continues to this day, people are almost embarrassed about talking about the fact that we take care of sexual problems as if somehow that become unneeded because people are sick with a virus. It seems to me it’s more needed than ever. We need comfort. We need love when things are tough and we’re the people that help make that happen. So can you expandable, have you seen some of that or what’s your idea about … My point is nobody needs to make an excuse about going to work and talking about sex, even though people are dying.

Dr. Ibrahim:

You know what, I’d never would’ve thought to bring that up, but you’re absolutely right. Just to carry out that in, on the aesthetic side, now that everybody’s doing Zoom meetings and they’ve got 4k and high-def cameras looking at their face from two feet away, anything and everything above the nose, people who are doing that have never done it. Because the other is what you just said about the sex part, with so many families that have both spouses working, but now they’re both working from home and they found themselves in an environment where sex is okay at two o’clock in the afternoon, they want to do it. And a lot of couples coming in together. In fact, I’ve never had more couples at one time. Usually it’s one of the partners, almost always the female, that gets started and then the other one comes in after the fact. But I’m seeing more and more new patients enter as couples to optimize their sexual intimacy together because they’re spending so much more time together. And yeah, that is something that I would not have thought to bring up, but I see it a lot now.

Charles:

So we only have seven minutes left. Thank you for hanging with us for the whole hour. I got two questions that have been sent to me. Well, first of all, this is something I know that you’ve had a lot of experience with surgically before there was ever an O-Shot. So talk to us about in seven minutes, your ideas about the O-Shot, where it comes into the treatment for stress and urgent continents. And then last, have you had any thoughts about the new magnet Emsella treatment?

Treating Stress Incontinence and How the O-Shot® Procedure Integrates with Mid-Urethral Slings

Dr. Ibrahim:

So let’s talk about the incontinence. First of all, you see the literature that talks about 51% of women over the age of, just making up, 40 something report incontinence. And whenever I give talks, I go, “That’s the biggest wrong number in the world.” If a woman has gone through menopause or she’s ever, let’s say 50, and she’s had one or more vaginal deliveries, they’re incontinent. But they’re all used to it. Their mother wear her pants when she caught the sneeze. Their best friend wears her pants when she’s jumping rope. And so, so many women don’t even complain about, “I have this today.” Healthy as hell, thin, fit, 50 year old woman, three vaginal deliveries. It’s on our form. I don’t care if you’re coming in for Botox. It’s one of the questions on the form. Do you leak when you cough, sneeze, laugh, job, et cetera, then in parentheses stress, urinary incontinence?

Dr. Ibrahim:

And she didn’t even think to mark it, but I looked at her history and her age and I just couldn’t conceive up. And sure enough, she says, “Oh yeah, whenever I do jump rope, which is like three to four times a week, I’m always leaking.” And I go, “Well, let’s talk about what we can do.” And so it’s far more common and I advise everybody to make sure it’s on your list of questions, because if you’re going to be part of your club and you’ve learned how to do the O-Shot, then I will address their incontinence at every single visit until they tell me either, I don’t want to hear you talk to me about my incontinence again, Dr. Ibrahim, or they go ahead and [crosstalk 00:54:34].

Dr. Ibrahim:

And [inaudible 00:54:34] is, is I have done enough slings, enough mesh, enough tax in my career. And [inaudible 00:54:42]. They were horrendous and they had brought with issues. If I had had the O-Shot when I was in residency, I would have done a third of the female vaginal incontinence procedures that I did as a resident. One-third. It would have knocked out probably at least half, if not two thirds, of the cases that I had done. Because so many women are completely dry after one or two O-Shots. Every one so far has been dramatically improved if not, parentheses, cured. And again, I thought of how long is that going to last? I don’t know. I don’t have that crystal ball. Some, they’ve never had to come back and some come back once a year and some in between. So-

Charles:

The other surgeons in our group will tell me that even if the woman chooses to go straight to a sling, they’re usually still almost always grateful that they were offered a non-surgical solution first. Because there’s this urban feeling that surgeons want to cut, but actually surgeons want to get people well. And sometimes that means surgery, but there seems to be an appreciation for a surgeon that has something other than a scalpel in their bag. And then if they choose to go straight to the swing, they’re happy that they were offered something else. And so I’m glad to hear you supporting that idea. And you’ve seen it even work with urgent continence. I’ve heard that, but it’s interesting that you’ve seen it as well.

Dr. Ibrahim:

So when somebody comes in, they might stress incontinence stress, even though we’d give them the examples. And I find out that it’s urge. You’re itching to go. You’re back of the cold section of the grocery store, and you’re looking for the bathroom and, “I got to go, I got to go.” And you wait yourself before you can get there. That’s urge incontinence. I’ve had some women say, “Look, I’ve had a friend. She had urge incontinence. You told her ahead of time. Look, I can’t promise you anything for urge.” I go, “But it’s not going to hurt it. And if anything, it might make sex better.” And if it helps her incontinence, both of us are going to be thrilled to pieces and damned if it didn’t help her incontinence. And so I can give you the anatomic reasons why stress incontinence is held by the other shot, but I have no idea how urge it is. And I’m not talking about the incontinence. I’m talking about the urgency, the neurologic feeling in the head and the bladder that have to go. It helps with that. And I have no idea how come.

Charles:

Yeah. I’ve got some, as I’m sure you do, some theories about that, but we’ll save that for the … I’m telling you guys, every time I’m in the room or on the phone with this man, I learn a lot. He’s innovative, but he knows the science as well as anybody on the planet. So if you’re looking for a hands-on class, I can’t tell you, you just need to go see him. So last thing and then we’ll close it down. What’s your ideas about the magnet that’s being used to help incontinence?

Dr. Ibrahim:

To be very quick and short about it, of course I download it and I do not own one.

Charles:

Okay. All right. So guys, I think that we better shut it down. And lots of people are busy and I’m always honored. Everybody’s busy. So I’m honored that you made the call, honored that Dr. Ibrahim made time for us, and I’ll make sure this recording is posted somewhere soon. You should get an email automatically, but if you don’t just look forward on the membership site soon for the video and the transcript. Thank you for being on the call Dr. Ibrahim. I’m always grateful to you.

Dr. Ibrahim:

Thank you so much, Charles. I do appreciate your kind words and I appreciate your comments on the workshop.

Charles:

Yes, sir. Bye-bye.

Dr. Ibrahim:

Bye.

Dr. George Ibrahim

Dr. Ibrahim’s Next Workshop<—

Dr. Ibrahim is Western North Carolina’s only physician certified by the American Academy of Anti-Aging Medicine. He has been specifically trained in the use of bio-identical hormones, having passed both written and oral exams. A former Duke University Clinical Professor of Urology, Dr. Ibrahim’s experience with hormonal balancing goes back decades.

George Ibrahim, MD is a well known, board-certified urologist who has been professor at Duke University.

Dr. Ibrahim’s Next Workshop<—

Research showing “COVID-19 lockdown dramatically impacted on psychological, relational, and sexual health of the population. In this scenario, sexual activity played a protective effect, in both genders, on the quarantine-related plague of anxiety and mood disorders.”<–(it’s ok to treat sexual disorders during the pandemic–it’s needed) (click to read)<—

Penile rehabilitation research<–

More research about the O-Shot® procedure<–

More research about the P-Shot® procedure<–

More Workshops<---

Apply for online training for the O-Shot® procedure<–

Apply for online training for the P-Shot® procedure<–

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

Topics Discussed Include the Following…

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

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

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

Transcript

Beauty Analysis. Face & Labia…the Math of Beauty

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Another reference concerning the math of beauty

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

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

 

Click to see the after photo<–

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

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

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

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

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

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

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

PRP Tune-Up

click to see PRP basic science research<–

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Charles Runels: Interesting.

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

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

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

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

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

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

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

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

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

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

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

Charles Runels: Yes.

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

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

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

So, people don’t usually like that.

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

Charles Runels: Interesting. Yeah. Very good.

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

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

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

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

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

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

Charles Runels: Beautiful!

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

FDA Approval of PRP

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

FDA & PRP click to read<–

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

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

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

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

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

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

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

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

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

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

So that’s the quick version of that.

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

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

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

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

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

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

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

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

Next classes world wide with faculty of multiple specialties<—

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

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

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

Good-bye

Next Workshops with Live Models<---
Relevant Links

Beauty Analysis Facial Topographical Map<–

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

FDA & PRP<–

 

 

 

 

 

Cellular Medicine Association
1-888-920-5311

 

Cell Doctor News. January

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CMA Research Overview

In early 2010, a salesperson called on me, John Deeds, and showed me a brochure about a centrifuge approved by the FDA to prepare PRP. He said, “Use PRP like Juvaderm®. You get new volume and new blood flow, and there’s never been a serious side effect.” … CONTINUE READING
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Is the O–Shot FDA–Approved?

Of the female sexual dysfunctions, dyspareunia will most disturb a woman’s relationships. A woman can accommodate a decreased libido and anorgasmia, but she will often completely avoid any contact when she suffers from dyspareunia. But, when it comes to treating the various female sexual dysfunctions, anorgasmia offers the biggest challenge to cure. Testosterone helps … CONTINUE READING
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When a Patient Isn’t Pleased With Their Results

As far as I know, anyone who was unhappy with a procedure that I did (going all the way back to 2003 when I first went to an all–cash practice) was refunded every penny that they gave me. That feels good to me. It’s better than if I still had their money. … CONTINUE READING
© 2018 The Newsletter Pro. All rights reserved.

Q & A. Vampire Wing Lift™, Keloid, Premature Ejaculation, Stretch Marks

Relevant Links (listen to the end for a do list that brings new patients who need you)…

Hope this is helpful.

Best regards,

Charles

Charles Runels, MD
Cellular Medicine Association
1-888-920-5311

Q & A. Leveraging National Press, Vampire Breast Lift®, O-Shot®, P-Shot

Vampire Breast Lift® procedure in the Sun
Vampire Breast Lift® procedure in Daily Mail (Bec Judd)

From an open-mike discussion sponsored by the Cellular Medicine Association (for our members only)

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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…

1.

http://www.dailymail.co.uk/tvshowbiz/article-4962476/Bec-Judd-wants-vampire-breast-lift-fix-dark-nipples.html

2….

Forget vampire facials! Vampire BREAST LIFTS are the latest bloody beauty fad

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-

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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)

[00:10:41]

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.

Ontraport

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.

Priapus Shot®

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-

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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?

Desmond: Correct.

Speaker 1: Okay. I’m gonna put that in the chat box. Thank you for that top. Let’s see.

Desmond: Welcome.

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.

Desmond: Alright.

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.

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