O-Shot® for Improved Sexual Function. International Society of Cosmetogynecology. Vegas 2018

International Society for Cosmetogynecology<--

Cellular Medicine Association<--

Transcript

Dr. Marco Pelosi III: Our next speaker is probably best described as the Michael Jordan of platelet rich plasma, Dr. Charles Runels from Alabama, that pioneered the O-Shot® [Orgasm Shot®], the Vampire [Face]lift®, the P-Shot® [Priapus Shot®], and he's taken all the abuse and he's given the world some very, very useful procedures for everyone. He's going to talk about the studies he did and the studies done in platelet rich plasma in regards to sexual function. Dr. Runels, it's a pleasure to have you here.

Dr. Runels: Thank you for having me.

I'm going to go through a whirlwind look at research that's been done where people have used PRP to help with sex. Much of the research has been done by the people in our group, and I've described many of them in this room who have done this research. It's a for-profit organization, but we pay for research, we pay for education, we pay for marketing for our providers. Just to echo what you just heard, sex is much more than about just having fun. Rainer Maria Rilke said it's just so correlated to the creative experience that it's affecting how we do our work, how you do your presentation, and how - of course - relationships and families.

I want to echo that sentiment, and remind us that back in 1980, if you look in 'Urology' - this was 'Urology' 1980 - the most common cause for erectile dysfunction was thought to be 85% psychogenic. Here's a quote from 'Urology' where urologists were encouraged to become counselors, because most of erectile dysfunction was thought to be psychogenic. Of course, I'm echoing the penis stuff because if you take a penis and shrink it and unzip it, that becomes a clitoris. I'm thinking most of the research will eventually apply to that. Certainly, our attitude is applying because we're back in the ... We're not, I'm preaching to the choir, but many of our colleagues are back in the 1980's and saying the main thing we have for sexuality for women is counseling.

My thinking that perhaps, as you guys do, some of the pathology that applies to the penis may apply to the clitoris, and maybe some of these women are suffering from actual genital histopathology, not just psychogenic problems. We have this one FDA approved drug now for female sexual dysfunction that's a psych drug, flibanserin. It's a useful drug, but obviously, we need much more and maybe we should think in terms of systems, like we do for the rest of the body.

Platelet Rich Plasma.

Obviously, this is not a new idea. This is from, this month, over 9,000 papers indexed in PubMed about platelet rich plasma. Our orthopedic colleagues, our dentist, our facial plastic surgeons have worked with this, and all we have to do is take their ideas and then hopefully people in this room will extend what I'm about to show you and just take those ideas and adapt them to the genital space. Here's some of the growth factors we know about. There are many more. They have these effects. These are good things for the genitalia. Down-regulating autoimmune response, proliferation of fibroblasts, new angiogenesis, the adipocytes enlarge and multiply - think labia majora, collagen production, neurogenesis and maybe some glandular function.

Find Nearest O-Shot® Provider<--

There's never, in all those 9,000 papers, I still cannot find one serious side effect. No granulomas, no serious infection. PRP is what your body makes to heal when you do your surgeries and help prevent infection. Obviously, there are always certain things that can happen, bruising and such, but if you have a serious life-threatening complication from PRP, you will have the first recorded in all of that 9,000 plus papers. That's a nice thing.

Next Workshops With Live Models<--

We have commercially available methods for preparing it, within 5 or 10 minutes of the bedside, and the devices are FDA approved. So you guys don't get confused, obviously the FDA does not approve your procedures. That's a doctor business. They don't approve blood that belongs to you, just like your spit and your saliva and your skin. They tried, at one time, to control eggs and the gynecologists said, "Hell no." So they don't control eggs and they don't control blood, but you should use an FDA approved device if you do this [approved for preparation of PRP to go back into the body].

Autoimmune Disease

Here's some of the ideas about down-regulating autoimmune response. We have split-scalp studies showing that PRP helps alopecia areata better than triamcinolone. More hair growth that comes in thicker. Here's rat studies looking at rheumatoid arthritis. What do we have in the genital space? We have lichens sclerosus. We did some before and after pictures where you use stem cells mixed with PRP, and before and after pictures show improvement. Of course, that's two variables because you have stem cells and you have the PRP.

We took the same idea and just used PRP. Andrew Goldstein worked with me on this, and we had two blinded dermatopathologists. The protocol was biopsy, PRP, wait six weeks later, another PRP injection, and then six weeks after that, another biopsy. Two blinded dermatopathologists out of George Washington University did not know the before or the after. We showed statistical improvement in both the histology and symptomatology. Here's our histology. You can see obviously, that's the same magnification and we're showing decreased hyperkeratosis. That's obviously healthier tissue. A layperson could tell that's better. Of course if you look at the gross pictures, lady on the left as you guys know, she has pain wearing her blue jeans. The lady on the right is back to making love to her husband. They've invited me into their close Facebook groups and I saw a post a few months ago. Quote says, "I was sitting next to my husband, whom I love, last night. I was afraid to hold his hand because I was afraid he would become aroused and I'm bleeding and hurting today." That's what you guys are helping.

We published that in 'Lower Genital Tract Disease'. We extended it because it worked. We published this past January in the journal of the American Academy of Dermatology. You have some science to go do this now.

One of our providers, Kathleen Posey, who's a gynecologist out of New Orleans, took this idea and then she said, "Let's do some dissection in the office", and she presented this in Argentina, published it in the same journal 'Lower Genital Tract Disease'. Here's one of her patients, where you can introduce [inaudible 00:06:44]. It had been 12 years since she had had sexual intercourse, penis and vagina intercourse, with her loving husband ... 12 years. She was being followed by a dermatologist on high dose clobetasol. Kathleen dissected it out in the office and then injected PRP ... 8 weeks later, she's having comfortable sex with her husband. She's now 3 years out. She's had to be treated with PRP, not repeat surgery ... PRP now, 2 other times a year apart to maintain that result. She now has a series of 60 or so patients that she's now going to publish with similar results, where she's dissecting out - as you guys know how to do - treating the [inaudible 00:07:27], but then following that with PRP injections to help the healing and decease the autoimmune response.

Find Nearest Priapus Shot® Provider<--

That same doctor, Casabona, repeated his study with lichen sclerosus in men [BXO], and showed with just PRP alone ... This study of 45 men with repeat treatments ... It is cumulative, 2 to 10 treatments, the same thing. All of them stopped their steroids. None of them started back. Only one went on to have circumcision.

Peyronie's

Peyronie's disease, another autoimmune disease ... This came out this month out of Wake Forest, where they took men and they followed their results with Peyronie's disease. Not only did their Peyronie's improve statistically, but they also improved their erectile dysfunction by 5 on that scale of 5 to 25 that the urologists use. For some reason, thankfully, they threw in one woman just for good measure, and showed that it helped her incontinence. They just tucked that in as an aftermath.

Ronald Virag, as you guys know as the legendary vascular surgeon who was first to present the idea of intracavernosal injections for erectile dysfunction, out of Paris. His big thing now is PRP for Peyronie's. He just published a study where he showed that this is comparing PRP with Xiapex, which is a $50,000 series of injections, FDA approved version of collagenase. He showed that PRP works better with few side effects. There's a risk of about 1 in 30, that actually go from a bent pencil to a fractured pencil and a limp noodle. You don't see that with PRP. You see the side effect is the erectile function improves. He showed the same thing, actually, in his studies that erectile dysfunction improves by an average of about 7 on that 5 to 25 point scale.

Wound Healing/Scar Resolution

Let's think about the [inaudible 00:09:29] literature. Look at this, there's so much of this out there. This is looking at post-operative adhesions, lots of studies looking at scarring with microneedling and PRP. This is a split-face study comparing PRP with microneedling verus PRP ... Excuse me, microneedling with saline or Vitamin C serum and split-faced studies in PRP wins. Dr. Sclafani did some studies in the cosmetic space looking at increased collagen production and fibroblast activity, and never a neoplasia documented. People worry about that. This is not indiscriminate blindness blind growth. You don't worry about carcinogenesis when you do surgery and it's the same PRP that's causing healing. There's actually some helpful immune processes that go on, that you could argue actually might help prevent cancer. I'm not going to make that argument but it might need to be made one day.

If you look further, here's a wound healing study looking at reepithelialized exposed bone and tendon of the foot and ankle. When I took that and applied, this is a hypertrophic scar that was a year old from cortisone, and then using PRP and Juvederm or HA filler, this is a few days later, a month later, and that's a year later. Now, take that and think, "How could I use that in the genitourinary space?" Doing that anecdotally, we have many of the members of our group are seeing help with episiotomy scars or dyspareunia, pelvic foreplay instead of injecting that pelvic floor tenderness with triamcinolone. Physiatrist for the past ten years has been using PRP, your sports medicine doctors. Now, when you palpate it, consider injecting with PRP instead. Dyspareunia from mesh and that unknown dyspareunia, we're seeing this is where we need you guys to help extend the research. The science is there that it should help and it seems to be helping. Not 100%, but about 80% in people with dyspareunia.

Mesh Pain

Here is a look at a gentleman who did ... He took the mesh out and then he patched the hole with a gel form of PRP and showed benefit. We're finding anecdotally - no one's done this study yet, here's another one for you to pick up ... I'm giving you low hanging fruit. We're seeing anecdotally that if you inject in the distribution of the pudendal nerve, which seems to be inflamed in some women with mesh pain, that their pain will frequently go from 9 out of 10 down to 1 or 2 out of 10, without even taking the mesh out. Just another place where we need some research done.

Interstitial Cystitis

Here, we have rat studies looking at inflammation. Let's think about this one. Here's a rat study where they modeled cystitis and we are seeing in chronic interstitial cystitis without even infiltrating the bladder, just infiltrating in the periurethral space, some of our women are getting better. I've had two separate urologists call me and say, "Charles, I can't believe it. I was doing this and expecting not this to happen. I have these patients now who have had chronic interstitial cystitis pain for years, and it's gone." Not 1005 but finding out who's going to respond and who's not and why, there's a lot of variables that need to be thought about that you guys will hopefully do the research.

Penis Growth

Here's a study that came out in the 'Journal of Sexual Medicine', where a guy took ... the [inaudible 00:12:51] men who have an erection of 3 inches or less and then he treated them with PRP, combined with a pump, and showed that if you repeated it every time you did it, it grew by about 7 millimeters. I've always thought if I could give you a guarantee half an inch to an inch with anything, I'd get my picture on a postage stamp. I don't have that yet, but I can tell you that we're seeing about 60% of the time we do this procedure, men will see some sort of growth.

If you look at the neovascular space, there was a study out of Southern California that was published in the 'Journal of Sexual Medicine' where they transferred adipocyte stem cells to the penis of diabetic rats. They showed new endothelial cell growth and increased nitric oxide activity in the dorsal nerve. Would that be helpful in the clitoris? Probably, but the interesting thing is the adipocyte-derived stem cells were attacked and they died. The postulate was the improvement was from the growth factors.

Penile Rehabilitation and Erectile Dysfunction

I have seen what [inaudible 00:13:52] have seen in that when you inject this in the penis, erectile function goes up on the average of about 5 to 7 per injection. Think about nerve repair. We have rat studies modeling prostrate surgery, showing that the nerves improved with PRP and so we have, again, another clear place where we need studies if you add this now to the usual protocol for rehabilitating the penis post-prostate surgery ... would you see benefit? We have seen that in some of our patients who are a year or two out who failed the rehabilitation part of that. Would that help your patients who have, say, numbness and decreased function from riding their bikes too much, or trauma? I don't know, but it's worth thinking about and publishing research about.

Next Workshops With Live Models<--

In thinking about where to put this, where we do our O-Shot, when we do PRP to the anterior vaginal wall, we're putting it as distal from the bladder as possible. We found that it works better. We're essentially making a liquid sling. Think infiltrating and getting ready to put in the mesh. That's what we're doing. Very simple, only we're using a material that has never caused a granuloma ever. Doing that, frequently our patients will have their incontinence go away that day from the actual liquid and as it's replaced with new tissue, it never recurs. Usually, you'll have to repeat the procedure at a year or two out depending on the etiology. Sometimes it lasts longer.

The interesting idea is what might be happening with those [inaudible 00:15:21]. They become more active, and does that help with sexual function? The other place we put it is in the actual corpus cavernosum of the clitoris. We use [inaudible 00:15:29] ultrasound visualization and see it flow down into the body of the clitoris by the pubic ramus and the wave form goes to what you see in a flaccid penis to what you see in an erect penis.

Improved Orgasm & Libido in Women

That's my time, almost done. Just 30 more seconds. Here's a pilot study we did where we showed that in women with female sexual distress, that it dropped by an average of 10 and female sexual function went up by 5 when you do what I just showed you. Here's a study that Dr. Neto, who may be here, published where he looked at incontinence and sexual function down in Brazil and showed that 94% of the people loved it. The question here is how would you combine it with your energy source? It works great in the face if you do laser and follow it with PRP ... better results, faster healing. Is it going to ... We need people to help us work out the algorithms. Not everybody has laxity, but when you have something, when do you use which treatment and when do you combine it with PRP? We need those answers, because I don't have them yet. This is possible helps.

I am done. Thank you very much for having me. I put all these references at that website, if you want to go download them. Thank you. You guys have a wonderful conference.

Dr. Marco Pelosi III: Thank you Charles. Beautiful

More about the Cellular Medicine Association

O-Shot® Research<--
P-Shot® Research<--

Upcoming Workshops With Live Models<--

Dr. Runels (inventor of the O-Shot® procedure) & Nory Talk about Female Orgasms & Spirals that Go Up & Spirals that Go Down.

Transcript...

Nory: So, Dr. Runels, let's begin by you telling our readers a little bit about your medical background and anything else you'd like to share with them.

Dr. Runels: As far as my background as a scientist and a physician, I had a strong math interest and worked for three years as a research chemist, and then I went to medical school and wound up doing emergency medicine for 10 years or so, 12 depending on when you want to start counting. My boards were in internal medicine, so I started doing some research and opened a practice, did some research with hormone replacement, so 18 years ago, before Suzanne Somers wrote her first book I was doing testosterone pellets and did some research projects with growth hormone. That's what made me in tune with women's sexuality. I didn't set out to be a sex doctor. I set out to take very good care of women as a physician.

I don't really even like the word. I don't like when people say that's "alternative medicine." This isn't alternative medicine. This is medicine that looks for what works, and if it happens to be something not in a bottle that you buy at the pharmacy that doesn't make it alternative. So, if I'm using, say, nutrition, how is it that two milligrams of medicine can be more powerful than the pounds of food that you put in your body? Or, if I'm using exercise or if I'm using your blood in the case of these procedures, if I'm using things that are backed up by research, like walking three miles a day has been proven to do more for your heart and your blood pressure and your risk of heart attack than any drug on the market, including blood pressure and diabetes drugs. So, that's not alternative, that's science.

So, anyway, I have a strong science background and I was doing research, but I also had a background, i used to work as a trainer at the YMCA, so I understood physiology and exercise from a personal standpoint and from coaching a lot of people back in my college days as an exercise guru sort of guy. So, all those things sort of meshed together and as I was taking care of women in the most excellent way I could think of, using science, but not always medicine. I'm not anti medicine, but using science and hormone replacement all of a sudden I had a flood of women 18 years ago realizing that somehow they were getting better and their friends were getting much better than what was being done down the road by what was done for women 20 years ago which was just Premarin, basically, don't do any blood tests, throw a little estrogen at you and hope that your hot flashes go away.

So, that's sort of how I got to where I am as far as being attuned to women's sexuality because they would come crying to me about what was happening with their life, and you can't do their hormone replacement, in my opinion you can't take care of people well unless of think of endocrinology and you can't do endocrinology and hormones without asking questions about sex. It turns out that those questions I was comfortable asking about sex were unusual, and I didn't know it at the time but most doctors are afraid to talk about sex. They don't want to talk about sex. And research shows that if a woman asks their doctor about sex, which most of them never do, only 14% ever ask their doctor a question about sex, even though half of them have problems, research shows that the doctor will change the subject after answering the first question over half the time.

So, I didn't realize I was being unusual in listening and trying to heal the relationships when women would come crying and say, I love my husband so much but I'm afraid to tell him that I'm having pain when we have sex or that I'm not aroused, because I love him and I don't want to tell him, I don't want to hurt his feelings. And they've never told their doctor, their husband, or their preacher or their best friend.

So, that's sort of the quick version of how I got to be the guy that's now ... has done research in this area and working with a couple thousand doctors in 50 countries.

Nory: What gave you the idea for the O-Shot®?

Dr. Runels: The O-Shot® was a sort of a coming together of ideas, one, with the research background as a chemist I was already into instrumentation. I actually did some work, one time considered becoming a biochemical engineer, not a biochem but a medical engineer, designing instrumentation. So the centrifuge has fascinated me. I ran a wound care center at a hospital nearby when I was a [inaudible 00:04:51] so I was into healing of wounds. Then I had the women crying about their sexuality and I had an injection practice because I found that women oftentimes want to quit losing weight, because when they lose the weight in their face their wrinkles start to show up more. So I had made myself an expert at cosmetic injections, not just for the benefit of that but to help encourage women to continue to lose weight with me when I got their metabolism right.

 So, now you got wound care, injections, and all those things come together, and I thought, oh, wow, what if you took this technology where you're using platelet rich plasma and heal tissue and I pulled it over and used it in this arena where women have problems with pain or sensation or function of the genitourinary space. So, that's kind of how it all came together.

Nory: I read a story about the Priapus Shot® and feel free to tell this or not, and we don't need to include it in the interview but I sort of remember that you had a partner, wife or a girlfriend who said, hey what about me?

Dr. Runels: I gave you the short version. So I'll fill in the blanks. So, when I was first introduced to platelet-rich plasma someone was telling me ... because I was doing cosmetic injections, use it like Juvederm in the face, you get new volume, new blood flow, and there's never been a documented side effect, serious. So, to this day there's still with over 9,000 research papers, now getting to Priapus or the penis shot, but there's never been, in 9,000 published research papers one serious side effect from platelet-rich plasma, as in no infections, no necrosis, no neoplasia, no granulomas. But you get new blood flow. It's been documented in multiple biopsy studies you get new blood flow, you get healing, all the [inaudible 00:06:47] regulation hyperimmune status and other things.

So, when he told me that, new volume and new blood flow, I thought, well, I've got a better place than my face for a new volume and blood flow, thinking like a man. So, I thought I'm going to do things with the face before I try this in my penis. So, for four months I injected faces and I watched and yeah, people would come back and their face would be glowing, and they would tell me their friends and family were saying their face was glowing. So I thought, okay, let's try it. It took me a while to get up my courage because I thought when it makes this matrix, which it forms a yellow goo like surrounding a scab, when the matrix forms, that goo forms, that's what holds the growth factors in place. But if that's in a wound say, on your hand, you've got blood flow coming from beneath so it's not a big problem. I was thinking if that goo formed inside a penis it may cause necrosis or cause something bad to happen, maybe an erection that won't go away or priapism or something.

But I tried it and it worked. It seemed that it was helping a little bit with size and a little bit with erection and some of my patients, a lot. So, I had been doing that for a few months, and following the other part, because I actually, to this day, take care of more women than men. I was doing this for selfish reasons, thinking how to make things better for men, and I thought shoot, if I could make it to where the average man could grow his penis a half an inch I'll get my picture on a postage stamp.

Three Categories of Women Who Suffer with Sexual Dysfunction

So, I'm working on that but I'm still mostly taking care of women, and I have a heart for women and actually part of what led to me taking care of the men is that, when I would get women happy and make them ... take a woman who's 40 pounds overweight, she's 40 years old, she feels tired and her sex drive is low. When she loses the weight and her sex drive is high and she can think well again, three things could happen. I got to where I could almost tell when the woman walked in the room, which of the three it is.

Okay, picture that woman. If she's got a lover who's kind to her, who's healthy, who has a good sex drive, they could live happily ever after, there's nothing left for me to do. If she's got a lover who's been abusive to her because she's been overweight and low self esteem and now she gets her sex drive back, she's out the door, there's probably nothing I should try to do. I don't know, but there's probably nothing I can do because she's been kind of under the thumb and now that she's got her sex drive and her health back she's gone.

The thing that bothered me was the third category, and that's the woman who comes in and she loves her husband and he's not well. Now, you make her well, she's got a sex drive, and the man or woman that she loves can't keep up with her. Now you got a problem, because they love each other and you've created a mismatch that's causing a conflict. That bothered me. So, for that reason I made myself an expert at men's sexuality.

I'm working on that part of it but I have been following what has been done for injecting around the urethra. That's been done for the past 15 years, with collagen, with hyaluronic acid fillers, with collagen, with hyaluronic acid fillers, with, it's really what you're doing with the sling. It's just a way of changing the contour of that area with some of the surgeries. So, finally I had this girlfriend at the time, who said, "Hey, I want to try that." So I said, "Okay, let's try it." And the first 24 hours she was so, I mean, she was always a good, she always enjoyed sex, but she became really almost like she was on some sort of drug. If you think about it, drugs are, you know the only bad thing about drugs is that they make you sick, they get you put in jail, but what if you had a drug that was legal, that made you happy, and wasn't going to put you in jail? That'd be a good thing.

You could say running becomes a drug like that for some people. The endorphins from running. So all of a sudden, here's something I've done that in theory should make her body healthier, but it was like a sex drug to her. So I thought, and she was just insatiable for about the first 48 hours, so I thought, I should try this with some people that have problems, because it makes sense it should work. So the first woman I treated after my lover had been abused by her ex-husband in the genitalia. She was scarred in the vagina and the anus to the point where she couldn't have relations without horrible pain, so she came over on her lunch hour and I treated her and a few months later she was literally engaged to an old high school lover because the pain was gone, and something that took me 30 minutes on her lunch hour just changed her life.

She's the one who actually said, "Hey, this has made my incontinence go away. I've lost weight because I'm running again." I thought, 'Well Josh should've thought of that.' So my patients, the people, the women and men who've trusted me are really the people who are responsible for this coming about, because they trusted me enough to let me do what the science said should work. Again, [play the 00:12:02] words, plasmids, that's been researched for the past 15 years for wound healing, but using in that space was a new idea and the people who loved me and trusted me enough to do that were really the ones who taught me the procedure.

I had an old teacher that told me, he said, "You know, if you want the best textbook, it's not the textbook, it's the patients you're taking care of." And my patients, if you're writing the textbook, then you're writing it from what your patients are teaching you, and that's what's happened with me.
(Chapter 15 introduces the O-Shot® Procedure & is Written by Dr. Runels)

Nory: You know, it's just a beautiful philosophy and your humbleness is, tells me a lot about you.

Dr. Runels: Well, I don't know, it's really, there's really no, I don't know if you can call it humble when there's really nothing that I can claim, except maybe tenacious, being tenacious. Because you know, I didn't go make this brain, I came with it, and I, the people who've been around me gifted me with their trust, but it's kind of you to say. But I still think most of what we have is a gift from somewhere, wherever you decide that's from is your philosophy, but I feel like most of the good things we have are gifts. Then we decide if we're going to take care of them or not. That's kinda how it works.

Nory: You know, Erin told me, this is a little off subject and we don't need to include it in the video if you don't want, but she called you a 'transcendentalist.'

Dr. Runels: Oh, I don't, I'm not even sure I'm 'good,' but I think that ... Emerson had it right when he said really our goal in life should be to be a perfect pipe. But the pipe becomes most useful when it becomes as empty as possible. I don't know what that makes me; maybe just makes me an Emerson fan, but that's kinda my goal.

Nory: Well I come from a Unitarian Universalist background so I just said, "He's close to my heart."

Dr. Runels: Yeah, he's an amazing guy. I think he came pretty close to being an empty pipe, didn't he? Or clean pipe.

Nory: Getting back to our interview, I think you've answered a lot about how your women patients' problems impact their lives, but I'm curious to know, besides the O-Shot® and the nutritional supplements and the hormonal supplements and the other [techniques 00:14:43] you use with them, do you use any other technologies besides the O-Shot®?

Dr. Runels: ... The things that can go wrong with sexual function really almost cover almost everything that can go wrong with the body. Sexual function is, I consider it like the cherry on the top of good health. For example, if someone's depressed, for whatever reason; hypothyroidism, tragedy, whatever it is, sex drive's gone. If someone's in pain, for whatever reason, there's no sex drive. If someone's got a fever. The sex drive, in my opinion, it can be faked, it can be maybe become artificial through some drug like cocaine or whatever, or maybe through someone being drunk or high or something, but true, healthy sex drive evolves out of many things that have to do with good health, good relationships, good connections. The best, even on a spiritual plane.

So as far as, when you say 'what other modalities would I use?' Let's just take, for example, a problem like can't have an orgasm. That could be low testosterone, and in that case they need testosterone. It could be pain because they've got a scar from having a big baby and they're associating sex with pain, so that's not gonna lead to orgasm. In that case the O-Shot® may help. It may be decreased sensation in which the O-Shot® might help. Maybe from previous surgery or childbirth. It could be they're recoiling from sex because they were abused at some point. At which point sexual therapy might help or some other form of family counseling.

So I like to think of the O-Shot® as a tool, and when the dysfunction involves any sort of dysfunction of the tissue of the genitalia, then that tool comes into play. Now, there's this dichotomy of thought, and I think you can tell I respect the idea. I mean, I'm a big fan of Erickson as well, I respect the idea that the mind is very powerful ...

and can do things that we're probably very not close to understanding at this point, but the idea to try to cure something with therapy that might be made better with something, a physical thing, seems to me like taking things ... Jefferson, Thomas Jefferson, 'I always grab things by the smooth handle.' The smooth handle is not always therapy. But sometimes it is THE handle. So, for example, if someone has, back to that example, if someone has trouble with orgasm and they have the pain from intercourse, sending them to therapy is not the right thing. I like to think of it like a system. On the other hand, if they were abused and their genitalia is working normally, the O-Shot® is not the right thing.

I've been in situations where the therapist somehow had the impression that I thought I had a magic shot that makes everything better. I don't, but on the other hand I don't think therapy necessarily makes everything better either. I like to think of it as a system, and it's a very complex system. For example, we think of a respiratory system, and if you said you're short of breath, that could be because you're anemic. It may not have anything to do with your, if you're profoundly anemic because you're, whatever, you've had colon cancer for the past 20 years or 5 years and you, without anyone knowing it, your red cell count is low, you can't carry oxygen, so you're short of breath because you're anemic. Where another person it may be bronchoconstriction. So one person needs a blood transfusion and iron and a colonoscopy, and the other person needs a bronchodilator.

I think because, again, because of these archaic, almost Middle-Age attitudes that it's not okay to take care of a vagina, it's not even okay to say the word 'rejuvenation' in the same sentence with the vagina, even though it's okay to say it with a face, it's okay to 'rejuvenate your face,' but let me talk about 'rejuvenating your vagina' and somehow I'm doing something ethically wrong, that's just archaic. In my opinion.

Find Closest O-Shot® Provider<---

To avoid that sort of 'I've got a hammer so everything's a nail' mentality, I like to think of a system. You can have a respiratory system but I think because of that archaic thinking, no one's ever said, "Hey, let's think of an orgasm system." It's a pretty complicated thing, and it involves having ... Let's talk about the respiratory system; the nervous system has to be working, sending the signals to breathe, which can be changed by lots of things. You have to have ... Bronchials have to be the right diameter. You have to have the right amount of red cells flowing through your blood stream. A lot of things have to do with respiration.

In the respiratory system, you have a neurovascular system, a nervous system, and endocrine system, and the reason we think about systems is because it emphasizes the interplay of lots of different components, and there in my opinion, there's an orgasm system. Testosterone has to be high enough, prolactin has to be low enough, you need a little dab of estrogen for some carrying, probably need a little bit of oxytocin for some love in there. At the same time you need to have sensation. You need to be conscious, you need to be not in pain. You need to have the right serotonin and dopamine, mill you and your brain to have libido. You get it. There's this whole complicated system, and all the O-Shot® does, all it does is make the tissue, that part, those receptors, and the functionality of the genitalia more healthy. That's all it does.

Orgasm & Spirals Up & Spirals Down

Having said that, it can have profound effects on all of it because we were taught ... I was taught in medical school, this is how sexuality works. You have arousal, then you have a plateau, then you have an orgasm, then you have a refractory period. There's this up, flat, and then down like that. It's actually much more complicated than that, especially for women. With men, maybe we're more simple minded. I feel pretty sure we are, actually. What we know for sure, that women are much more sex machines. How many men can have five orgasms back to back to back, with no refractory period? That's not so uncommon for a woman. How many men feel energized after an orgasm? Very common for a woman.

There seems to be, no matter what you want to say the cause of it, there seems to be a different ... I can talk to you a few hours about what I think it is, and what's going on there, but there seems to be a different reaction to sex. That's just the orgasm part. That's not even counting all the rest of it. What I'm getting to, and how the O-Shot® may affect multiple components, including the psychological ... If a woman, there's a spiral and it go up and down, if a woman has arousal, and then she has sex, and then it's a bad experience, she's ... For whatever reason. We can think of lots of horrible reasons it might be bad. But, it's a bad experience for her. Then, she doesn't go back to baseline. She's at a level now to where it's more difficult to even become aroused.

Let's say she tries again, and it's another bad experience. She's spiraling down. I think there's some women that are spiraled so far down because of abuse, and they attempt something with a lover and maybe they're abused again, or something bad happens, and they're so down, they just spiraled, spiraled down. Now, the other side of that, someone becomes aroused, a woman, and she has an encounter and she's ... It's glorious for her. She's respected, she's loved. She has this beautiful experience. Physically, emotionally, spiritually. Now, when it's time for possible sex again, she's at a different state. She's more easily aroused and there's a spiral up.

Women's Health Talks About the O-Shot® (Orgasm Shot®) Procedure

That spiral up and down, that's not my idea. That was actually presented, and its been talked about for a few years in the Journal of Sexual Medicine, and other places. What might be new is that, I think it's possible, that in some women my O-Shot® can help break the trend down. Or maybe help accelerate the trend up. For sure, I've seen it in women who have pain, break the trend down. We do the procedure, and then I have some techniques that I tell them to do so that they can test the waters, so to speak, on their own. Then they find, "Oh. Maybe I'm not having pain." Maybe they tentatively have sex with their lover and, "Oh. Wow. I didn't have pain." That doesn't mean they're not still worried about it, but they spiraled up a notch.

The next time they're not as tentative. There are ... Maybe that might apply, in even cases that don't have to do with pain. I think we're seeing our shot affect other areas because of that complicated system. It triggers other things in the mechanism. It's still not a magic shot.

Nory: Remarkably complex. Remarkably complex, the woman's ... The whole ethos. Not just her sexual response, but all that goes into making that ability to orgasm, or not. You're painting a very much bigger picture for me than I had had.

Dr. Runels: I think it's really ... It's very ... Prideful for us to think we have a deep understanding. Even when you expand it this broad, for example, we know that if you have a massage, your oxytocin level goes up. It makes people more open to pleasure. Oxytocin’s a small peptide chain made by the pituitary gland, which is attached to the brain. You might as well say it's part of the brain. There are over 200, that's 2 with 2 zero's behind it, peptides made by the pituitary gland. When we do some extensive blood tests, we get 20 blood values back. Oxytocin, DHEA, free and total testosterone, on and on and on. Still, just Kindergarten compared with what's going on up there.

The idea that you might push one button and it affects 10 other things ... For a simplistic example, if I raise your growth hormone level because you've had brain trauma and it's low, it's going to lower your thyroid level. If I raise your testosterone level, it's going to lower your thyroid bonding globulin, and you'll have more thyroid because I gave you testosterone. It will probably also increase your insulin like growth factor I, or your Somatomedin C because you'll probably create more growth hormone. That's just one example, of one hormone affecting two others.

Who knows what's happening with the other 200. That pituitary gland, remember, is attached to your brain. When you get fearful, and your heart rate goes up, it's because your cortex said, "Hey. I'm afraid." And your pituitary gland spat out some stuff that told your adrenal glands to release some stuff. It all started up here. I don't mean to say that what's going on up here is not important. I think it's extremely important. I do think there are ways to push buttons, whether it's hormonally or physically with our O-Shot® that have rippling effects throughout the whole system that can be beneficial.

Nory: That seems like a pretty good place to conclude the interview. I know that you're a little pressed for time.

Dr. Runels: I was honored to speak with you, Nory. I commend you ... I know we had some conversations earlier, so before we wrap it up I just want to commend you for having the courage to, one, talk about sex, because it's a courageous thing to do. Just bringing ... Broaching the topic will bring criticism, even to healthcare people like ourselves. Whether it be writers, therapists, doctors, doesn't matter. When people broach the subject of sex, there becomes a recoil that you can't even run ... I've been banned from Facebook. You can't run an ad, even if it's bringing people to something that's a medical procedure. I can't ... My Facebook ads have been banned because I talk about sex.

It's troublesome that there's this idea that ... As we spoke earlier, there's somethings that people can have go wrong, and they invite the utmost sympathy from everyone. You can have the flu, and people want you to get well, and you let them know without hesitation. They send you get well cards, or you can have cancer. Try getting schizophrenia. Or bipolar disease. And even though those are chemical imbalances, that it's not fault of the person, there's no reason to be ashamed of it, nevertheless, there's ... Continuing, we're not in the ... This is not the middle ages where we should be saying these people are witches or something, or they're possessed with the devil, but it's a chemical balance. They shouldn't have to be ashamed of it, but they are.

Many of them are. And they're ... In the same way, sexual problems, you won't see anybody posting to Facebook. They might post they got the flu, or they broke their arm, come sign my cast. You aren't going to see anybody post to Facebook, "Oh. I've got painful intercourse. Would you pray for me today." Or, "I couldn't have an orgasm last night with my husband. Would you give me a prayer?" Have you ever seen that on Facebook? You'll see broken arms all day long. And it's because there's a social stigma for it. But yet, that same thing, is so critical ... Emerson said sex and beauty is the ... He actually just said beauty, but I throw in the sex part, because I think that was his generic way of saying sex. But he said beauty was the scaffolding of love.

Yeah, you may reach a place where you don't need the scaffold, but I think most mortals need the scaffold to build a relationship. That's why I think more younger women, and older women complain. That's my long way of bragging on you, for you having the courage to talk about this. I'm happy to wrap it up, but it should go through this. If there are other questions that you get from your readers, or that just occur to you, we'll do Volume II. Anytime you want. Or III or IV.

Nory: You know, this was amazing. I didn't expect ... I was not expecting the depth. It was not what I asked for, but it was beautiful.

Dr. Runels: Thank you.

Nory: I feel way more optimistic I think, than you. Honestly, I do. I feel very optimistic. And I'm waiting for those bullets that you say are coming, those arrows. I know it would probably feel really good to you, to punch some people who have those attitudes about vaginal rejuvenation. Would you like ... Would you appreciate the opportunity to write a forward for my book? A short one, that does a little of that punching back?

Dr. Runels: Yes. I would love to write you a forward. The answer to that is yes. I would love to write a forward. As far as my, the way I visualize it, I see it more as ... When I was working in the ER, if someone came in just drunk and stupid, because of some drug they were on, and they would often try to hurt me. My goal is not really to punch back, it was just to control them from hurting anybody until they got their brain back. I look at these people, they're just so blinded by ... It's crazy to me.

I'll meet them in a thing and they'll say, "When you publish some research, then I'll start doing this." I'll say, "Well, you know we've already published five papers. And there's 9,000 papers about PRP. Have you read any of them? Or are you reading Marvel comics? What are you reading?" You're not reading any of this if you're reading Superman and Revenger. It's so funny to me that we're ... That's the way I look at it. It's not really punching back, as much as it is ... Anticipating their daggers, and building the intellectual shields to neutralize it until they get their brain back.

Nory: No. No. You're so nice. You're so nice, and I'm so grateful. I can't tell you.

Dr. Runels: All right. So, let's do this thing. I look forward to talking again, and I'll make this recording where you can take whatever you want and share it.

Nory: You are the best. Please give my regards to Erin. She's wonderful, too.

Dr. Runels: Thank you, Nory. Goodbye

Nory: Bye-bye.

Recent Press--Woman Orgasm<--

Find Closest O-Shot® provider<--

Apply to Become an O-Shot® provider<--

Our Research<--

Cellular Medicine Association

Why Women Should be Angry…

Apply to become an O-Shot® provider<--
Apply to become a Priapus Shot® provider<--
Apply to become a Vampire Facelift® provider<--

Find an O-Shot® provider<--

Save

Save

Krystie P. Lennox He is an expert in [inaudible 00:00:02] class that sold out very quickly. Those of you [inaudible 00:00:16] I'm sure you'll learn tons. Dr. Runels, to you.

Charles Runels: Thank you. So thank you guys for having me. Leonardo da Vinci said that he wanted to do miracles. And I think that if you are careful about selecting your patients, you can come close to doing miracles with PRP. And I think we might as well face it, if we wanted to make money, we could take half the energy and do real estate or something. But most of the people in this room, we're here because we want to do miracles.

I have a couple of things, disclaimers, I have a couple of non-profits, no companies making money, although we've been offered some interesting money to put our brand names on different devices. We do have a group though, and much of what I'm telling you today comes from that group. I've become more of a note taker. We've published 2 papers so far this year, and 2 more that were approved this month. We're in 50 countries now; this slide has gone up a lot just in the past couple of months. Many of the ideas that I'm giving you are from the people in our group. Many of whom are in this room, so my hat's off to them.

Facial aesthetics. You heard some interesting ideas yesterday about shape, and I think it's worth noting that some mathematicians have thought about shape. Leonardo da Vinci, Richard Feynman, actually 5 Jewish scientists won Nobel Prizes this year. Richard Feynman was a physicist who won 2 Nobel Prizes, and he was also interested in beauty. This is one of his notebooks where you see him sketching women on the same page where he's doing math, and he had ... If you go to the internet, these are all his sketches. Here's another mathematician, Dr. [Marcourt 00:02:24] who was a bridge engineer and became an oral surgeon, and he did that topographic map. Lots of measurements about shape.

Here's the guy for whom the movie The Elephant Man was made, and you can see that that shape would not be attractive no matter what color or texture. But the Blue Man Group, you can see even though they look like they're made of plastic, and they're blue, they would still be attractive because of the shape. So you heard a lot about shape yesterday, and when it comes to fillers, or HA fillers, I think there's nothing that beats an HA when it comes to shape.

A lot of people who are disheartened by platelet-rich plasma, it was because they were trying to make platelet-rich plasma change shape. On the other hand, if you know how to combine it, you can do some amazing things with shape if you combine the HA with the PRP. To me this is the perfect candidate for an HA filler. You can see that she has loss of volume in the cheeks, she's got some drooping. This is with an HA filler alone, this is no PRP, this is just an HA. Here's HA done the wrong way. Chasing nasolabial folds and that's me trying to correct it. So a lot of people tried to use, 8 years ago when I first started using PRP, a lot of people were trying to use it as a standalone, like an HA, and it will not work if you do it that way.

On the other hand, combined it can do ... Literally do some miracles. So what is the technology all about? I mean what exactly is it? I know a lot of you are doing this. This is just a picture of a test tube full of blood. If you just let it sit there, and do nothing to it, eventually it would settle as like a sediment, like if you put sand and dirt in water and just let it settle, with the heaviest settling to the bottom first. And the centrifuge just makes that go faster. So the red cells are the heaviest, they're at the bottom, and then that little pink thing in the center there is called the buffy coat, where most of the platelets live.

Now most of this technology evolved out of trying to heal hard to heal wounds. Dentists trying to heal a wound where someone had radiation for throat cancer. An orthopedic surgeon trying to heal tissue of the knee, where there's almost no blood flow and cartilage. That's where most of this technology came and a lot of the reason that the urologists, the gynecologists, and the facial plastic surgeons didn't really have to look at it, because it's a very vascular space, so there's not really a need to try to work on hard to heal tissue because it's not hard to heal. The devices that we are using were developed over the past 15 years by the dentists and orthopedic surgeons, and were just rebranded and repurposed for facial aesthetics and for the [inaudible 00:05:12] space, when we started figuring out that they worked in those areas.

So sort of an interesting opportunity in time if you think about it. Back in the 80s, as an example, the gynecologists were all using endoscopic surgery, but the general surgeons were not. The gynecologists were very proficient at doing hysterectomy endoscopically, and the general surgeons were still filleting people open to take out a gallbladder. And the first person to really teach how to take out a gallbladder endoscopically was a gynecologist. Something similar is happening now, in that you have a huge body of research that's been published over the past 15 years about how to use platelet-rich plasma, but it's mostly been looked at by orthopedic surgeons and dentists. And you are in opportunity, I think, to now take that research and apply it in these spaces. I'll get to some of the research we're doing, but first a couple of ideas about how it happens, and what about the FDA.

I hear this a lot, "Is this procedure FDA-approved?" And you may have patients who ask you that, about PRPs are FDA approved. The FDA does not govern your hair, your urine, your skin, or your blood. It's the Food and Drug Administration. You can also call it the Food, Drug, and Device Administration, and I'm glad we have the FDA, but they do not govern your blood. However, they should be governing, and they do, the devices that are used to prepare blood to go back into the body. So if you're doing these procedures, the correct answer is that the FDA does not govern your blood, but that's a procedure. Just like if you were suturing a wound, the suture material is a device that must be approved by the FDA. But the FDA has nothing to do with how you suture and tie a knot when you're sewing up a wound. In the same way, the FDA should and does govern the devices that process blood to go back into the body, but once that blood is in your hand, that's your business, and the FDA is never going to have anything to say about that.

On the other hand, it's called minimal manipulation. So if you take a piece of skin from one part of your body and you transplant it to the other, that's your skin, FDA has nothing to do with it. Same thing if you harvest an egg for implantation. But if you do a lot to the tissue, the FDA says, "No, this is no longer tissue, it's a drug," and they've been warning us for the past 5 years that, "We're going to start cracking down on the stem cell clinics, because stem cells are a drug." So just be careful, if you're doing or advertising stem cell work, you probably need to have that under the umbrella of the Institutional Review Board, because the FDA now counts that as a drug. But they specifically do not count platelet-rich plasma as a drug.

There's lots of PRP systems out there, and they all have to do with just the best way to get those platelets, because again this was developed with the idea of getting as many growth factors as you can into a tiny space. For example a surgical wound in the jaw, or in the knee, where you want a lot of growth factors in a small space. We don't really know what the absolute best therapeutic concentration is for easy to heal tissues. In the joint space, the research seems to indicate that somewhere around 5 times concentration of whole blood works the best. Honestly, I'm not so sure that whole blood has platelets in it. When you do surgery, when you do a biopsy, you don't have to go use the centrifuge. The same process, the [inaudible 00:08:52] cascade, the growth factors caused that wound to heal. So 1 to 1, the same concentration that is whole blood, that's all you need to heal a surgical wound.

I'm not so sure that wouldn't work with the face. We don't know. But there's 2 basic kinds of kits. There's a single centrifuge, like a gel kit, and there's a double centrifuge. The orthopedic surgeons would tell you, "You need a double centrifuge and 5 time concentration," but we don't know yet what we need for the face, and the [inaudible 00:09:27] space. Always laugh when people say, "Well there's no research to back this up." If you just go to PubMed and put in "platelet-rich plasma," there's 9,000 papers that have been published. Just 1 of the manufacturers, and there are over 20 of them that are FDA approved, just 1 of them sold over a million tubes last year alone. Do you really need to do, if you show wound healing, and fibroblast activity, and [inaudible 00:09:53] in the foot, do you need to go repeat that research for the arm and ear and the genitals? Maybe you do. But maybe, at least for some indications, you don't.

Section 1 of 5 [00:00:00 - 00:10:04]

Section 2 of 5 [00:10:00 - 00:20:04](NOTE: speaker names may be different in each section)

Charles Runels: But maybe, for the least some indications, you don't. And so we are publishing studies specifically for the genitalia and the face, but it's laughable to me when people say there's no research to back up what we're doing. Here's some of the growth factors. The other thing that people often get worried about is well, growth, is it indiscriminate? Like throwing fertilizer on your lawn and you're gonna grow bad horrible things like neoplasia? Or is it more intelligent? I think it's more intelligent because, if you think about what you're doing, these growth factors were ... They're made to heal a wound. So it makes sense that it would help fight infection, that it might help fight foreign bodies and nurture healthy tissues versus unhealthy tissue. And indeed, in all of those 9,000 plus papers, there's never been one neoplasia documented, there's never been one serious side effect documented, except in one case where it was injected into the eye, where they had a retinal detachment. So no one do a shot anywhere near the eyeball.

And if you had a serious side effect, you would literally have the first one known to mankind. So although it doesn't cure everything, this is something that can change lives and you never lose sleep over it. You're not going to cause blindness, necrosis. You're literally injecting what the body would use to heal itself if you did injury.

IG [inaudible 00:11:34], as a matter of fact, is what we use to document and measure acromegaly, that's one of the growth factors that are released. And people who have acromegaly, or high growth hormone levels, like Tony Robbins and these big guys. They have 25% less cancer than in the general population. So you could make the case that perhaps it's even protective for neoplasia.

So here's some of the things that PRP does. Collagen production, fiberglass neo angiogenesis, neurogenesis. Stefani did some nice work with some gel tubes back in 2010, 2011. Published quite a bit showing fiberglass activity and [inaudible 00:12:13] proliferation and not just numbers, but enlargement of fat cells, which makes it intense, right? What's the easiest thing to grow in you body? It's fatty tissue. And fat cells just go crazy with this. Which, if you think about it, that's helpful, because if you had fat in the cheek or the breast, you might be able to make those fat cells, enlarge and multiply and have a nice cosmetic effect. And indeed, I'll show you some pictures shortly, where that is true.

Now this is just an example of we do have double blind placebo randomized control studies in different parts of the body. Here's one with [dis 00:12:48] disease. Here's one where Stefani injected the back of the arm and biopsied and demonstrated all these tissue types generating healthy tissue. But here's two studies that are particularly interesting to what we're doing. In these studies, they had people who had exposed bone and tendon or the foot and ankle, from trauma. So the skin has been torn away. You're trying to regrow the skin.

And in one group, they had a layer cake, where you had an HA, like a Juvederm, but orthopedic version of it. And then you had on top of that, PRP. And the other group just got the HA covering. And they looked to see who could grow the skin back. And the people who had the layer cake, which is what we do when we do it in the face if we're trying to change shape, and HA followed by PRP, you do your best work with an HA filler and then polish that odd with platelet rich plasma, that's what they did. And the people who got that layer cake more easily and quickly grew back healthy tissue to cover the exposed bone and tendon.

So here's an example of a scar that I treated. You can see this woman had, the year before I did this, she had a cortisone injection in the ankle. This was little college woman who was embarrassed to wear a dress to sorority functions because she had cortisone that caused atrophy of the skin. And if you look carefully, there's to hypopigmented scars. One of them is where she was cleated playing soccer. And then when it didn't heal properly, she went to the dermatologist who biopsied it. And the dermatologist said, "Yes, this is atrophy from cortisone. There's nothing I can do." And then six months after that, so a year after the cortisone, she was a friend of one of my sons and asked me if I would treat her ankle. So she came in and you can see it goes all the way up the leg. And so I put one CC of an HA filler there, and five CC's of PRP. So you can still see the needle marks. This is a few days later. This is a month later. This is a year later.

It's now been seven years since I've treated this woman's ankle. She's an insurance salesman now. I bought some insurance from her to pay her back for me showing her ankle around the world. And it still looks like this. So when people ask you, "How long does this last?" Well, the answer is, if the edeology is gone, it's permanent. You do not have to go spin blood and do a centrifuge to keep a surgical wound from dehiscing, so if you have an operation and you suture a wound together, when it grows back together, it's there permanently. On the other hand, if the edeology is still present, then it will need to be repeated. For example, with we use PRP for a woman who has dyspareunia, she has dryness and painful intercourse because she cannot be on estrogens and she's had breast cancer. This is the balm. That's an easy treatment for us. And she will get lubricate and she will love you for it and you will change her life. But she'll have to have a repeated treatment in about a year because the edeology is still there.

When you treat a woman, however, who's had an episiotomy scar and has severe pain after she tore after she delivered a child, you will also change her life and she will love you for it. And I have people that I've treated like that six, seven years ago and they are still comfortable because they haven't delivered another 10 pound baby. With the face, however, age still goes on, as you guys know. We can't freeze people in time. So when you do this with the face, they're probably going to want ... They'll still want their Botox, they'll still want their everything you do to maintain the face, the creams and everything else and they'll probably want this procedure done again in a year and a half to two years, just because of age. But the tissue that grows there is permanent.

This is what you can do with one syringe of a filler. The fillers last longer and it's like it polishes off your work. This is one syringe of filler and five CC's of PRP. So you have an effect that is I think more natural, in some ways more dramatic than you can do by using larger volumes of filler. The other thing if you think about that ankle, it's growing based on the genetic code. When you use your filler, it's what you're seeing. It's your eye. But you cannot make an abnormal shape with PRP because the shape that grows is dictated by the genetic code. So it's a really nice combination where you make some structure with your filler, but then let the genetic code polish off the structure you've made to create a really nice natural shape, which of course is what your patients want. They want younger and they want natural.

Micro needling has been more well known. As you guys know, we have a name that we use to help promote that. We're all over the news. This time of the year is a great time to start to join our group because people love talking about us around Halloween. I won't say the name, but you guys know it. So if you use micro needling ... Split face studies have been done for scarring and for just rejuvenation and anti aging type effects. Comparing micro needling with platelet rich plasma versus micro needling with vitamin C, micro needling with platelet rich plasma compared to micro needling with saline, and the PRP wins. Multiple studies. Those are two examples. And the same thing with the hair. That treating alopecia areata, treating hair loss. Most women will get all their hair back. Men will get about 30 to 40 percent of their hair back. And those studies have been done over and over now. So much has come out in the past couple of years.

So let's switch to the sex part. I hope that the women in this room become angry. You have reasons to be angry. If you're not angry when I finish this next part, I don't know. Maybe you're not listening. Because you should be very angry with what I'm about to tell you next. So before I get to that, the people ... I can see several people in our group in this room, and they will tell you that this becomes some of the most rewarding things that you will ever do in medicine. If you think about it, even when you're doing the face, you're really a love doctor, is what you are. Because why do you need your face. You relate to the people you love. You relate to the people you work with.

If someone throws a baseball at you, you cover your face and your genitals because those are sacred and the reason they're sacred, it's because that's how we relate to our lovers. And Emerson called sex and beauty the scaffolding of love. This is me before I shaved my head. And those are my three sons. That kind of hair, [inaudible 00:19:46] about sex just doesn't work. This was more conservative. But this was me as an internist with my three boys. And the reason I give you that picture is so that you can see, this is not sex for pleasure, although pleasure's wonderful. This is sex for relation-

Section 2 of 5 [00:10:00 - 00:20:04]

Section 3 of 5 [00:20:00 - 00:30:04](NOTE: speaker names may be different in each section)

Charles Runels: - for pleasure, although pleasure is wonderful. This is sex for relationships. When sex doesn't work, then babies live down the street and they go back and forth and people get divorced and the ripple effect goes throughout the community. People are married for 40 years and they're soulmates, but they can't connect like they did when they were younger and it puts a strain. This is not just about pleasure. I've been amazed and the people in our group have been amazed at how grateful people are when you do these procedures and you save the relationships.

It's not just about sex. Real key talked about the creative experience being related to the sexual function. I have many women that I've treated who say, "Why should men have all the fun?" I don't even want a lover. I don't want a woman lover. I don't want a man lover, but I have sex with myself. My sexual function gives me energy and creativity. It makes me a better salesperson. It helps me sleep better at night. It makes me less depressed, so it's okay to love yourself. This is not just about even the relationships with another person. It's about relationships with your creativity. Sex is so all encompassing.

Now, this is the part that I hope makes you angry. In 1980, who knows what was thought to be the most common cause of erectile dysfunction. This should shock you. I'm 58 so I remember this. In 1980, the most common cause of erectile dysfunction, this is from urology in 1980, and I'll blow that up where you can read it, most instances of acquired impotence are psychogenic. It was thought to be 85%.

Urologists in particular were confronted with genital problems and may be best suited as therapists. It wasn't until we accidentally discovered that Viagra got a lot of these guys well who we thought it was all in their head that we figured out it's not 85% psychogenic, it's 85% neurovascular. I think it's useful to remember how not smart we were. Imagine being one of these guys where your erection won't work and you're trying to keep your marriage together and somebody's sending you home telling you it's all in your head. Okay?

This is the part that should make you angry. Female sexual dysfunction, what are we telling people? Education, counseling, psychotherapy. We finally got the first drug approved to help women with sexual function and it's a psych drug. You have to become a teetotaler to use it. It's basically a spinoff of a serotonin dopamine Prozac sort of drug. We're taking it every day the average is one extra sexual encounter per month. It's just for libido. Nothing for painful intercourse or trouble with orgasm.

What I'm about to show you, I have no intention to tell you that this is some magic shot. I still think you have to think about endocrinology and relationships and surgical problems like ovarian cysts and cervical cancer and all that. I also want to propose to you that the penis is physically and embryologically like a small ... the clitoris is very much like a penis and that maybe it may also have things that can go wrong vascular and neurologically.

To tell a woman that it's all psychogenic who has pain because she delivered a 12 pound baby and ripped her vagina is criminal in my opinion, or at least should make you angry. That goes on every day, "Oh, here's a little lidocaine cream. Go home baby. It's all right." I've had so many gynecologists tell me they do not want to talk about sex. Research bares it out, even though 40% of women will have sexual problems. They'll only have the conversation 14% of the time, and if they bring up the subject, the doctor will change the subject after the first question. Now, if you're not angry you should just go have lunch because that should make you very angry.

I don't claim to have all the answers, but I claim to have a tool that I think is useful and I'm about to show you the research that shows that it's useful. I hope that some of you guys will jump in on this revolution. Now, the sex revolution of the 1960's was it's okay for a woman to have sex. I'm from Alabama, so I'm from the Bible Belt. The 1960's I can remember as a child all the ladies carrying their New Testament around. Now, they all carry their 50 Shades of Gray around. Okay? Which is a good thing because now the new sex revolution, and this was a cover of a Newsweek magazine article about the time 50 Shades came out, is that now it's okay for women to want to have good sex. You don't have to put up with bad sex. We are part of that revolution.

Now, we just went through this. The reason I show you those pictures again is the idea that maybe if there's a genetic code and you put platelet rich plasma there and the tissue grows back to recreate tissue the way it was genetically intended to happen, maybe that might happen around the urogenital space and create something nice.

First, let me show you what happens with the breast. I'm not trying to give you something that would take the place of implants, but look what we can do. This was a woman who had two separate surgeries. First, to get implants at a major university in a big city from an amazing surgeon, but this just happens. You see where she has a little double bubble there? The cleavage is a little bit apart, so she had it repeated. This is beautiful surgery, but it's a nuisance, so she had to wear that blue bathing suit right there to cover up that little double bubble. I took two syringes of Juvederm, filled in that little double bubble.

Now, remember the ankle? What happened there? This is six months later. By the way, she looked like that immediately, but I'm showing you the six month view and the bathing suit she wears now so you can see that just like with that ankle, it's not going away because she recreated tissue to fill in that double bubble. I treated both breasts, so it also brought the cleavage.

Anybody in here think you might have a patient that would like you to do that for them? They love it and they can go ... I've treated Playboy Bunnies that shot, one shot three weeks after doing this. She could have shot the same day with a little makeup. I've treated women that went straight from my office to the swimming pool. People love this procedure. Not as a replacement for implants, but for a touch up for women who've got a little nuisance defect or for a woman who's not really wanting implants, she's just wanting a touch up to make her breasts more like they were 5 or 10 years ago.

As far as the safety of that, here's some studies showing the platelet rich mixed with fat helps the fat survive. Most surgeons are now mixing fats with platelet rich plasma before they put it in the breast and we have multiple studies showing ... I'd just as soon buy that, but there's two different really long-term studies looking at what happens with re-biopsy rates and cancer rates when you put fat in the breast trying to reconstruct post-breast cancer.

The trend is towards less cancer. It wasn't statistically significant. There was no increase in biopsy rates. No increase in recurrence of breast cancer. The trend was towards less, which makes sense if you buy the idea that platelet rich plasma is somehow helps fight infection, fight abnormal tissue. I'm not claiming this is an inoculation against breast cancer, but I think 20, 30 years from now someone is going to do some long-term study that shows that perhaps it decreases the chances.

This is another woman that I treated. That's day one. I use a combination of HA with PRP. I wound up using three Juvederm syringes and about 15 ccs of PRP. These are saline implants that are about 15 years old and that's 8 weeks after that procedure. Remember how easy fat grows and remember my ankle? This was a combination of fertilizing fat and using an HA filler to help correct, and her husband calls me up belated because he doesn't have to suffer with her through another surgery.

As far as the genitalia itself, imagine this woman walks into your office. She's got that callus because she has to use a vibrator that's like a jackhammer and it takes her an hour to have an orgasm. The reason is her ex-husband abused her and the genitalia, the anus and the vagina, and left her with so much scar tissue it hurts to have intercourse with a man. She feels unlovable. All of her hormones are normal. Multiple gynecologists. What can she do?

She saw me on her lunch hour. I gave her platelet rich plasma into that callus and into the scarring that she had. I didn't think of the idea that PRP helps scarring. We've known it for 10 years. It's just a new idea to it treats scars in the vagina. People are afraid for some reason to go down there, but that has collagen and blood flow just like your arm or your face. Six months later she was engaged to a high school sweetheart for something that took me 30 minutes on the lunch hour after she had suffered for years.

These have been reorganized recently, but these are the description of female sexual dysfunction. As I mentioned, we only have one approved drug by the FDA to help these problems. It's only for arousal and desire. Nothing for orgasmic disorder. The treatment for pain is lidocaine cream and-

Section 3 of 5 [00:20:00 - 00:30:04]

Section 4 of 5 [00:30:00 - 00:40:04](NOTE: speaker names may be different in each section)

Charles Runels: ... [inaudible 00:30:00] cream and anti-depressants. It's really aggravating.

Now when it comes to incontinence, who in here would put Radiance in the mouth? Nobody, right? Because it links to granuloma. But there's an FDA approved version of calcium ascorbate crystals called Coaptite to inject around the urethra, approved by the FDA for urinary incontinence. And as you might expect, one in 40 women get the granuloma, that has to be surgically removed, because it causes obstruction. But it does work, and it's approved because it does work. There has never been a documented granuloma from PRP. So, I didn't think of the idea to inject something around the urethra that you can use a little 27-gauge needle, and I promise you, if you learn it the way I teach it to you, they will tell you it hurts less than Botox.

People think the vagina is sensitive. You can literally make a laceration on the vagina without numbing cream. All the sensation is on the other side, where the clitoris drapes down around the vagina and the urethra. That was Doctor Grafenberg's big idea. Doctor G. for the G-Spot, that all the stimulation is happening on the other side of the vagina. So, you can do these injections with almost no pain, usually zero pain and have dramatic effects on -

This is just some of the research showing the granulomas that happen when you use the calcium ascorbate crystals.

But, you can do this without fear of granulomas and sure, it does not work all the time, but it does work in a young woman who's leaking because she's exercising or because she had a baby, and she's dripping a bit enough to where it bothers her at work and keeps her from doing aerobics. We get over 80-percent efficacy and even if it doesn't work, these ladies are usually very grateful that you have offered them something non-surgical before they went for a mid-urethral sling or had to take anticholinergic or a diaper. So they'll love you when you do this.

These are all the other things. All those still stay there. Kegels. They all still there. There's still a need for slings. But, in between physical therapies and anticholinergic, that's a big jump. Something that makes you feel stupid and constipated, you might want to try a 10-minute shot before you jump to that step. We get lots of press.

This is a cartoon of an urethra up on top, and the reason I put this here, I want to see where we put this injection when we're treating incontinence. It's like a liquid sling. Where you see a green material there, that's a cartoon of the skins glands and the periurethral glands. It's literally like the prostate gland of a man, but a man ejaculates once the fluid comes from the prostate gland.

And women who ejaculate, we have ultrasound studies and physiological studies. The fluid that comes from that, if you gave it to a pathologist, she would not be able to tell the difference between that and prostate fluid. It tests positive for PSA. It's not like the goal is to have all women ejaculating, but when you put the injection right there, you will have women who will tell you their orgasms become...they use words that sound like some infomercial. They're exploding and thunder and all sorts of things.

I can read you a text I got yesterday about this. It's amazing and women in their 60s becoming ejaculatory. Wasn't their goal to do that, but their orgasms become amazing. And I think part of what's happening is that we are making that tissue there wake up. So, the space most distant from the bladder between the vagina and urethra, that's where we do the injection. Simple little technique. Don't even need a speculum. Takes five minutes.

Now this is the clitoris. Most people when they think of the clitoris, they think about the part that you can see. But, you can see it drapes down around the vagina, and we have ultrasound studies that showing that when we inject the platelet rich plasma, which travels like saline, it's aqueous, we can see it going down into corpus cavernosi, bilaterally. And even the weigh form changes to what you see in a flaccid penis to what you see in an erect penis. It wakes it up.

Now, we have studies. This is one that was posted in the Journal of Sexual Medicine, showing that when you do an MRI of women who can easily have an orgasm and when you do MRIs with women who have difficulty with orgasm, the women who easily have orgasm tend to have a clitoris that's larger and closer to the vagina.

It's kind of odd thing to think about but when men and women have sex, they're basically rubbing penises together. Or you can say they're both rubbing clitorises together, however you want to look at it. But, it's the same structure. It's just like a penis that you unzipped when you think about the clitoris. And so it makes sense that if it's closer to the vagina, then it's more easily to have the orgasm. But the conclusion of the study was, "Well we know this, but we don't know what to do about it." I'm telling you there may be something to do about it. Because when you inject the clitoris with PRP, it wakes up.

Because one of the studies we did when we looked at female sexual function index, the female sexual distress score, and all the ranks improved. Satisfaction, which is another thing that I hope makes you angry. Satisfaction did not always improve. But this is the interesting thing about drugs in men verses drugs in women. If you went to approve a drug for a man that gets...of course we have over 20 FDA devices and drugs for men. Now I just told you we have one for women. Does that make you angry? It should make you angry. If it doesn't, just go have lunch.

Men have over 20. Women have one. And the one women have is a psych drug, but to prove, we'll say you want to get a drug approved for a man. All you have to do is to prove that it makes his penis hard. Boom. You can say. If you want to approve a drug for women, you have to approve that not only that said libido goes up, orgasms improve. You have to prove that she's more satisfied. That's not the same thing. For example, one of the ladies I treated became less satisfied, even though her orgasms improved because she said her lover couldn't keep up with her anymore. So, if that were a drug, it would have been disproved because she became less satisfied. So, hopefully that's making you angry.

It sounds cool to say that we will have a couple thousand providers in 50 countries, but there's 35,000 gynecologists in the United States alone and there's another 30,000 urologists. There's 200,000 primary care providers, including nurse practitioners and MDs, and we have 2,000 worldwide. That's nothing.

The average time to adopt a new procedure is 20 years. The first heart cath done in the 1940s. So the fact you're even listening to me makes you know you're a doctor. It takes 10 years to do the research. 10 years for people to adopt it. We're eight years in, and now, the first year we publish one study. This year, by the end of the year, we'll have five studies published this year alone. And so, the research is taking off and now is the time to jump in.

Again, I don't claim that these procedures are magic shots. You still have to think, "these are the hormones I think about when I think about a woman's sexuality". I want to know about her prolactin, her DHA, her testosterone. All these things. So, you don't quit thinking about this. On the other hand, it sort of aggravates me when I have a sex therapist want to therapy and counsel someone out of their dyspareunia when they have a [inaudible 00:37:51] up there that I can treat.

So, this is a young woman and I've just treated one side so you can see. I get a lot of flack from people sometimes, saying, "well you should just let women let their vagina be whatever it is," and that's okay. But what if we said the same thing about the face? When people say "Well, you should just age gracefully." always go back up and would you say that about your house? Would you not paint it? Not wash it? Not mop the floors? Are you just gonna let it age gracefully? If you have the right to take care of your home and your face, it is okay to take care of your labia. And so, this is just taking some platelet rich plasma and half a syringe of an HA filler and just treating one of the labia majora and it just wakes up and looks happier. Who wouldn't want that?

And I'm not going to show you my more dramatic cases. This is a woman in her mid-30s. When you do it to a woman in her 60s or 70s, we know sometimes they look in the mirror and start sobbing, because "Oh! That's what I used to see when I was 30." So, that's just something else.

Now, there's a lot of devices out there. Lasers, radio frequency, and it's not a new idea. When you do the face, we've known for 10 years, when you do a laser, you follow it with platelet rich plasma, you get a more rapid healing and get a better result. So, the same thing happens with the vagina and all the luminaries who are doing research with the different lasers and radio frequency devices, they will tell you that if you follow it with platelet rich plasma, you get a better result. I don't use the words, "tighter vagina" or because [inaudible 00:39:28]. Maybe it needs to be tighter. Maybe it needs to be more - maybe she's married to King Kong. I don't know.

And there are quite a few people who, due to surgery or because of some sort of disease process, they use dilators. So, not everyone needs a device, but I would say to you before you buy a device, consider doing it like you do at your facial practice. You start with your injectables, and when that part of your practice is going, then you buy the device. You don't the device and let it sit there and eat up your bank account while you look for patients. So, in the same way, once you get to where you're doing these procedures...

Section 4 of 5 [00:30:00 - 00:40:04]

Section 5 of 5 [00:40:00 - 00:58:28](NOTE: speaker names may be different in each section)

Charles Runels: ... patients. So in the same way once you get to where you're doing these procedures, then you go buy the device and some of them will benefit by using that along with your platelet rich plasma. So we published a paper this year in the Journal of the American Academy of Dermatology. I'm very proud of that article because until we published this, there was really nothing out there for women with blackened sclerosis other than [inaudible 00:40:26] which leaves them with a 10 percent chance of squamous cell carcinoma. Now that may sound rare to you, blackened sclerosis, but it's about one in 80 women and also goes undiagnosed and I'm showing you this eczema because imagine that's your labia because that's what it looks like, and these ladies because of our research have let me into their closed Facebook groups and the stories are just heart wrenching.

One woman posted I was rocking because it attacks prepubescent girls and it eats their labia away and by the time they reach puberty their labia is gone. So one woman's post how she was rocking her 12 year old and her 12 year old's crying and she doesn't know what to tell her. Another one posted she's sitting there on the couch with her husband whom she loves and has been married to for 20 years. They're watching television, get the picture? They're sitting on the couch. She loves the man, and she wants to hold his hand, but she doesn't because she's afraid he'll become aroused because that's what her vagina looks like, and she's hurting and bleeding and does not want to have to tell him no. Can you imagine the loneliness? And that's out there, and they're not going to talk about it with you if you're their best friend because they're embarrassed by it.

But anyway, so this is eczema, the same autoimmune process, both processes are autoimmune, and this woman was treated with PRP by one of our gynecologists and that's six weeks later, and she was disabled from that eczema, okay? So anyway, we published first in the Journal of Lower Genital Tract Disease. Andrew Goldstein spearheaded this research for us, and then we published again in the Journal of American Academy of Dermatology. This had already been done with stem cells, but most of the stem cell studies, the stem cells have to be in something, and they're usually in PRP. So it's really two variables. So we just skipped the stem cells and did it with platelet rich plasma by itself, and we showed benefit. These are biopsies from our patients and this is the same magnification, so you can see the hyperkeratosis, the paleness, the sclerosis, and this is after platelet rich plasma.

So that's what the pathology looks like, but this is what it looks like when you go to the bathroom, those ulcerative type sclerotic bleeding, cracking, painful lesions and that's what you see six weeks later. So that's a little article that we published, and this is, we had two [inaudible 00:42:54] pathologists who looked at it and told us it was better. This is what it looks like long term. This lady, you could put about half of your thumb in that space that used to be her vagina and she had not had sex with her adoring husband for seven years. You can't pull her clitoral hood back but it's under all that scarring. Normally if you release that, it would be back like that within a couple of months because of the active lichen sclerosus, but if you, in this study, and Kathleen Posey's one of our gynecologists who just presented this down at a big meeting in Argentina and this series will be published, actually it's already out online but it'll be in one of the journals this upcoming month. She dissected this out in the office, injected with PRP and that's eight weeks later.

This woman is now two years out and still having comfortable sex with her husband. She had not had sex with her husband for seven years and was being treated with high dose clobetasol, high dose cortico-steroids and still had that scarring like that. Now, if you're not a gynecologist you couldn't do the surgery, but you could treat the lesions in people who did not have that hood phimosis and they will love you for it and they will come from everywhere. So, I have 17 minutes. Let me get to the men side. So, John Grisham has a rule. He says he will never write a book that would embarrass his mother. So, Priapus to this being the Greek god of fertility is from, and spelled with a lower case letter is the synonym for penis, so that's why I call this the priapus shot so that I don't embarrass mothers and grandmothers out there. Sort of code for penis shot. This was the research that first kind of alerted me to it. This is from Urology 2003.

If you're using Viagra and Cialis or a penile implant or every one of the 20 something devices and drugs that are approved to treat erectile dysfunction, if you're using one of those, you might be making the penis hard but you're not correcting the underlining etiology, and so this article was just bringing up the idea 2003 that neovascularization was shown in animal models and maybe it might help in people. So, 2010, this article came out where they took diabetic rats and they used stem cells, adipocyte derived stem cells, injected the penis of that rats and then they harvested the penis. You can see why they wouldn't have men volunteering for this, but they harvested the penis and they demonstrated that increased nitrate oxide activity in the dorsal nerve and new endothelial growth which means a harder, bigger penis. Now, women, I think God sort of plays a bad joke on us because let's think about the normal progression. You get married at 20 or 30 or whatever and you have your soul mate and sex works. Now, the woman delivers a few children and her vagina's growing and the average man by the time he reaches 65, half of his endothelium goes away, so his penis is shrinking and her vagina is growing.

It's just a bad joke, isn't it? But when they come in as a couple and we inject the penis on the man, it's almost like, it is a romantic thing. They've been married 40 years, they're going on vacation. You inject his penis. Then he sits at the head of the bed while you inject her vagina and they're like little teenagers and you get a text a week later how they're rediscovering their bodies because they work different and they feel different. So they get to keep the soul mate and get new genitals. It's really very touching.

But anyway, in this study, they documented that but the stem cells were tagged and they died, and so they postulated it was the growth factors as in the PRP that caused the growth. So that's what encouraged me to sort of try this thing out first on my own penis and then other patients and now we've published. A study came out of India, one of our providers in India treating men who had smaller almost micropenis, three inches, showing that he could demonstrate growth, and for Peyronie's disease which is the equivalent of dyspareunia in women, we have a crooked penis that hurts. So Dr. Varag who is the Parisian urologist who came up with TriMix, now his focus is on looking at what platelet rich plasma will do for a crooked penis which looks like that. So this is the equivalent of a woman who hurts. The man loves his wife, but he knows if he gets an erection it's not going to fit into her vagina and it hurts and basically he feels like he's out of commission, and the treatment for that is surgery which can leave you impotent and with a shorter penis and it can recur because it's autoimmune.

You can cut out that scar tissue and next year you can have it back. Well, there's a new FDA drug out called Zyflex that costs 50,000 dollars for a series and Dr. Varag has a study, he's already published one but he has another one that should be out soon, I saw him present in Venice that shows that PRP works better with fewer side effects than Zyflex. So you will see that research published soon, and this is a procedure that takes you ten minutes in your office. This is the study that he, the first study he demonstrated that PRP works for Peyronie's disease. We combine it with a penis pump which also helps Peyronie's disease, and we get some of the hard cases for the urologists are our easy cases. Here's two rat studies that came out showing that PRP helps regrow the nerve in a penis. Where would you need that? In men who have prostate surgery. So there's a whole protocol about penile rehabilitation post-prostate surgery.

You think there are a few of those men out there, trying to get their penis to come back after they've had, there's just so many of these men, and many of them have gone through this protocol but when we go back through it, which is a, basically you keep, it's just a glorified water balloon so you keep the penis stretched out until it recovers blood flow, and then you add a daily low dose Cialis, but when we add the PRP to that protocol, I'm having men that are a year or two years out when it didn't work and now six months later they're back able to have sexual relations with their wife of 50 years. So really, really moving stories, and it's just using, injecting into the penis platelet rich plasma just like, it's easier than the face. It's just right there to look at. You go into the corpus cavernosum with your needle and into the glans penis and get amazing results.

Just like with a face, you can combine it with devices like the shockwave therapies. So you do shockwave to the penis and PRP afterwards, and get a synergy that's like crazy, so once you get to where you're doing two or three of these a week, you add in the shockwave therapy and you get even better results and a really nice cash flow and a lot of healthy patients. So, I have ten minutes left. I think I'm going to stop there. Can we take questions or should ...

Speaker 2: [inaudible 00:50:21]

Charles Runels: So that'll give us time for questions. Before I take questions just let me say we have a booth here and your money's no good, but we're giving away stuff. We give away research. We give away free training on [inaudible 00:50:35] because I know if I just showed you one of the videos to how to do the O-shot or the vagina shot that'd be 20 minutes of a video but we're giving away a chance to see those things and of course if you stay in our group then we might ask you for money but we let you look at everything and so go pick up, if nothing else, a free t-shirt. Okay. So, and that's where you can go online and get access to a lot of things for free. So, it's okay to take questions?

Speaker 2: [inaudible 00:51:03].

Speaker 3: I think I have a loud voice. I don't know. Can everybody hear me?

Speaker 2: [inaudible 00:51:23].

Speaker 3: Okay. So, when you said [inaudible 00:51:26] when you do [inaudible 00:51:28] then do you do micro-needling or are you going to PRP with injecting ...

Charles Runels: So that's a good question. So, if you want to, a lot of people tried PRP back eight years ago when I first started playing with it, and then sort of threw it aside because people said use it like Juvena. It doesn't work like a filler if you inject it subdermally. You get new collagen, but it's like your putting new upholstery but you're not changing the shape of the mattress. So if you want color, texture, the picture you see of Kardashian, she was pregnant when she had that done. PRP is very safe, but so micro-needling with PRP topically would help color, texture, but if you want shape then that would be going in subdermally with your HA of choice, doing your best work and then going subdermally with PRP behind it to polish off that work similar to what you saw with the breast and the ankle. Does that make sense? So the facelift would be subdermally, the facial, so frankly speaking what happens when a patient comes in if they have acne scars, I may use a filler as you saw those beautiful photographs yesterday in the lectures to expand it and make it better and then you put PRP subdermally and then micro-needling and PRP topically on top of that.

So use a combination of tools based on what you're seeing.

Speaker 3: So you're saying both, micro-needling and ...

Charles Runels: Depending on what I'm seeing. If someone came in like yourself who has a nice color, texture already but wanted a little touch up with the shape, then I may not do micro-needling. I may just do subdermally with the HA and the PRP, where if you were complaining of crepe papering under the eyes and some acne scars, I may just do micro-needling with PRP topically, so it's kind of based on what you're seeing.

Speaker 2: [inaudible 00:53:19] question. Okay, so [inaudible 00:53:22]. So I have a question.

Charles Runels: Okay.

Speaker 2: If you [inaudible 00:53:31] tear troughs, how much [inaudible 00:53:35]?

Charles Runels: Oh, yeah. Yeah. Thanks for asking that. So I'm doing a experiment with my face. I'm not sure if it shows up here, but I have a little trick that I do where I take a small [inaudible 00:53:46] of an HA and mix it with a larger [inaudible 00:53:49] of PRP and make a little emulsion and using that, you can use it, it'll flow in the tear trough like water but you don't have to worry about a Tyndall effect and you don't have to worry about causing too much unsightly lumpiness that you get if you're not careful with an HA. So, that's what I'm using in the tear troughs.

Speaker 2: [inaudible 00:54:15].

Charles Runels: Yeah. So it's okay to use brand names. Yeah. So, with that ankle picture that I showed you, that was Juvena multiplus, one cc with five ccs of PRP on top of it. What I found is that when you put the PRP, well you saw it. That ankle's now eight years out and still looks like that, so that combination is very dramatic. If you go to the wound care and it lasts longer. So if you go to the wound care literature, you see that using an HA with a PRP overlay sort of layer cake with amazing results. It just hasn't been published as far as I know in the facial aesthetics literature. I've been all about the sex. That's where our group spends about 200,000 a year on research and like I said we'll have five papers published this year because there are so many things out for the face already, but nothing. Are you angry yet? Hopefully you're angry. You should be angry when you leave here. That part makes me angry that women have one drug for sex and it's a site drug. So that's where my resources have gone.

Speaker 2: So we're going to take [inaudible 00:55:30].

Speaker 4: [inaudible 00:55:32].

Charles Runels: Have I treated children with lichen sclerosus? Was that the question? I'm sorry. I couldn't hear.

Speaker 4: Have you treated children with lichen sclerosus [inaudible 00:55:50]?

Charles Runels: So I personally have not, but we have gynecologists in the group who have treated children and they're usually in the nine to 11 year age group. Because it's PRP, there's really, there's nothing dangerous about your own platelets, and so there's no contraindication to treating a child with platelet rich plasma.

Speaker 4: [inaudible 00:56:21]? [inaudible 00:56:33] versus platelet rich plasma?

Charles Runels: Oh, yeah. Yeah. So, I like when sales people play with words and I have, did your dad ever tell you jokes you wish you could forget? So my dad told me about this woman who just, in high school, that just had sex twice, once with the football team and once with the basketball team, so you kind of have to know what people mean and I know people throw around the platelet rich fibrin matrix and say oh, that's, this one's not good because it has red cells or this one has a different kind of white cells, and all the sales people are confusing everybody, and this one makes fibrin matrix and this one just makes PRP. When you do surgery if you just stop and use your common sense, when someone does surgery or you scraped your knee as a child nobody had to sort out the different types of white cells, you just grew new skin. And it's the same process. It's the thrombin cascade is growth factors from the platelets and then it's recruitment of [inaudible 00:57:30] stem cells that migrate from the bone marrow and regrow healthy tissue, and it happens with platelets.

Now, as far as the matrix goes there is a kit that's out there that comes with a little calcium chloride. We activate the platelet rich plasma and it turns to a matrix in your syringe, and I sometimes do that. I just buy calcium chloride as a vial and add a few drops and I do that as part of the process, but when you inject platelet rich plasma into the tissue as soon as it contacts the collagen it turns to platelet rich fibrin matrix. So you can't use it without making that matrix and if somebody kind of plays the semantics game with you, although it's technically true that only one kit comes with the calcium, to make the matrix in the syringe. We're all making it every time you inject platelet rich plasma into the tissue.

Okay. Thank you guys for having me.

Lichen Sclerosus Before & Afters

Here's an example of what is possible using O-Shot® methodology to treat lichen sclerosus. These photos are courtesy of Dr. Red Alinsod, who also enjoys a world-wide reputation for labial surgeries and is expert at freeing the phimosis that can happen with the clitoral hood.

lichen-oshot-red-alinsod
Possible results after treating lichen sclerosus with O-Shot® methodology.Courtesy of Dr.Red Alinsod

Our Most Recent Research (click)<--

Here's where we are planning and raising money for future research (click)<--

If you (or someone you love) suffers with lichen, then we will keep you updated with future research if you will give us your information on the following form (your information will not be shared). We will also send to you information occasionally about research that concerns vaginal and sexual health that may relate to subjects other than lichen (but which will be of importance to all women).

Doctors may request more information about this methodology here (click)<--

Because of the sexual nature of the emails (using words like "vagina" and displaying photos of the vagina) the spam filters will capture all of the communications to you unless you confirm that you wish to receive the information by clicking on the email that will be sent to you (which may also be in your spam folder).

I hope and pray that we can eventually eliminate this horrible disease from the planet. Please help us in our quest by helping spread the word and by giving us your feed back.

Patient Reviews (click)<--

Here's the form that allows us to keep you up-to-date and let you know about future research.
All we really need is first name and email, but if you supply more it will help us identify you as a candidate for future research participation...

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save

Save