{"id":1761,"date":"2026-04-24T03:58:54","date_gmt":"2026-04-24T03:58:54","guid":{"rendered":"http:\/\/vampirebreastlift.com\/members\/priapus-toxin-dermabrasion-vs-vampire-facial-for-scars-vibrators-jcpm2026-04-14\/"},"modified":"2026-04-24T03:58:54","modified_gmt":"2026-04-24T03:58:54","slug":"priapus-toxin-dermabrasion-vs-vampire-facial-for-scars-vibrators-jcpm2026-04-14","status":"publish","type":"post","link":"https:\/\/vampirebreastlift.com\/members\/priapus-toxin-dermabrasion-vs-vampire-facial-for-scars-vibrators-jcpm2026-04-14\/","title":{"rendered":"Priapus Toxin\u00ae | Dermabrasion vs. Vampire Facial\u00ae for Scars | Vibrators | JCPM2026.04.14"},"content":{"rendered":"<div>\n<table class=\"c8\">\n<tbody>\n<tr class=\"c26\">\n<td class=\"c34\" colspan=\"1\" rowspan=\"1\">\n<p class=\"c2\"><span class=\"c32\">Journal Club with Pearls &amp; Marketing 2026.04.14 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/span><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/&amp;sa=D&amp;source=editors&amp;ust=1777006333981917&amp;usg=AOvVaw1iNTLwBBkjmBM8Oc1qvkIU\" target=\"_blank\" rel=\"noopener\">Cellular Medicine Association<\/a><\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"c2 c27\"><em><strong>JCPM2026.04.14<\/strong><\/em><\/p>\n<\/div>\n<p class=\"c10\"><span class=\"c17\">The following is an edited transcript of the\u00a0<\/span><span class=\"c17 c6\">Journal Club with Pearls &amp; Marketing<\/span><span class=\"c42 c31\">\u00a0(JCPM) of April 14, 2026, with Charles Runels, MD. \u00a0<\/span><\/p>\n<p class=\"c10\"><span class=\"c3 c45\"><a class=\"c4\" href=\"https:\/\/cellularmedicineassociation.org\/wp-content\/uploads\/2026\/04\/JCPM2026.04.14-final-edit-1.pdf\" target=\"_blank\" rel=\"noopener\">&gt;-&gt; The PDF of this live journal club can be seen here &lt;-&lt;<\/a><\/span><\/p>\n<div style=\"padding: 56.25% 0 0 0; position: relative;\"><iframe style=\"position: absolute; top: 0; left: 0; width: 100%; height: 100%;\" title=\"JCPM2026.04.14\" src=\"https:\/\/player.vimeo.com\/video\/1183770308?badge=0&amp;autopause=0&amp;player_id=0&amp;app_id=58479\" frameborder=\"0\"><\/iframe><\/div>\n<p><script src=\"https:\/\/player.vimeo.com\/api\/player.js\"><\/script><\/p>\n<h2 class=\"c11\"><span class=\"c7\" style=\"color: #0000ff;\">Topics Covered<\/span><\/h2>\n<ul class=\"c40 lst-kix_list_11-0 start\">\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Welcome, Session Overview, and Today\u2019s Agenda<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Meta-Analysis: Botulinum Toxin for Erectile Dysfunction<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Premature Ejaculation and Botulinum Toxin: Statistically vs. Bedroom Significant<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Botulinum Toxin for Eye Appearance: Lateral Lid Technique<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Dermabrasion vs. Microneedling with PRP for Scarring<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">PRP for Perimenopause and Ovarian Rejuvenation<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Platelet Concentration in PRP: Does It Matter?<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Vibrator Recommendations Post-O-Shot\u00ae: A Clinical Framework<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Pain vs. Anorgasmia: Different Protocols, Different Devices<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">Clitoxin\u00ae: When to Add Botulinum Toxin to the O-Shot\u00ae<\/span><\/li>\n<li class=\"c16 li-bullet-0\"><span class=\"c0\">J. Paul Getty\u2019s \u201cHow to Be Rich\u201d: Lessons for Medical Practice<\/span><\/li>\n<li class=\"c2 c30 li-bullet-0\"><span class=\"c0\">Q&amp;A: BD Insulin Syringes, 31-Gauge Needles, and Closing Remarks<\/span><\/li>\n<\/ul>\n<p class=\"c10\"><a href=\"https:\/\/runels.com\" target=\"_blank\" rel=\"noopener\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-3181\" src=\"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2025\/07\/image5-300x239.jpg?resize=300%2C239&#038;ssl=1\" alt=\"\" width=\"300\" height=\"239\" \/><\/a><\/p>\n<p class=\"c43\"><span class=\"c19\"><a href=\"https:\/\/runels.com\" target=\"_blank\" rel=\"noopener\">Charles Runels, MD<\/a><br \/>\nAuthor, researcher, and inventor of the Vampire Facelift\u00ae, Orchid Shot\u00ae (O-Shot\u00ae), Priapus Shot\u00ae (P-Shot\u00ae), Priapus Toxin\u00ae, Vampire Breast Lift\u00ae, and Vampire Wing Lift\u00ae, &amp; Clitoxin\u00ae procedures.<\/span><\/p>\n<h2 class=\"c33 title\"><span class=\"c22\">Transcript<\/span><\/h2>\n<h2 class=\"c11\"><span class=\"c7\" style=\"color: #0000ff;\">Welcome, Session Overview, and Today\u2019s Agenda<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">Thank you for joining the call today. I have, I think, some amazing papers that came out, and an interesting question. The question, which we\u2019ll get to later, was about vibrators. We used to have a vibrator we called the Intensity.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">They quit making it, but it was, it looked like a regular sort of vibrator with a rabbit and a dildo attached. The difference was that it had a tens-unit sort of thing embedded in the dildo part, so it would cause contractions of the vaginal wall with an electrical current sort of sensation.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It was very intense, almost too intense, but the company quit making it. The question is: which vibrator, if any, should we suggest to people after they have an O-Shot\u00ae procedure?<\/span><\/p>\n<p class=\"c21\">=&gt;<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333946412&amp;usg=AOvVaw0p-HvMS9AXqmuuqmqjaGC6\" target=\"_blank\" rel=\"noopener\">\u00a0Apply for\u00a0<\/a><\/span><span class=\"c13 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333946569&amp;usg=AOvVaw3aVORDBGjrxlxskDExRHSH\" target=\"_blank\" rel=\"noopener\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c15\">\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Then I came across a few shelves of books that I like to reread. C.S. Lewis had a thing that he said in his book about reading and writing. He said, when someone says they\u2019ve read a book, they usually mean they read it once. He said, if it was a good book, you really hadn\u2019t read it until you read it multiple times.<\/span><\/p>\n<p class=\"c2\">I have a few shelves of books that I try to read every year or two or three, and I pulled out one I\u2019ve been reading off and on since the 80s.<\/p>\n<p class=\"c2\">It was a series of articles that first appeared in Playboy, of all places, written by J. Paul Getty, who was a billionaire when there weren\u2019t many billionaires. The title of the series was\u00a0<span class=\"c6\">How to Be Rich<\/span><span class=\"c0\">, and I think you\u2019re going to be amazed at the ethics of this man, probably surprised.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I\u2019ll just do a quick review of that. It\u2019ll take two minutes, but one of the tips of his 10 tips came back to me and sort of haunted me. We\u2019ll have an open mic session at the end if you guys want it, and then that\u2019s it. So let\u2019s plunge into the research first, and then we\u2019ll get to those other things.<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/training&amp;sa=D&amp;source=editors&amp;ust=1777006333947561&amp;usg=AOvVaw1Ej1YNO_ucYJYUum9_oDEb\" target=\"_blank\" rel=\"noopener\">Apply for Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Meta-Analysis: Botulinum Toxin for Erectile Dysfunction<\/span><\/h2>\n<p class=\"c2\">This first part had to do with this one. So they reviewed the research that\u2019s been published so far on botulinum toxin for ED, and we've already covered all these papers, but we\u2019ve not had a meta-analysis on the subject.<sup class=\"c5\"><a id=\"ftnt_ref1\" href=\"#ftnt1\">[1]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">There are some that they didn\u2019t include. The papers we looked at, and I can pull them up for you very briefly, but the ones we looked at had to do with botulinum toxin in people that have people who, and this is the list of them, these are all papers where they did a placebo-controlled study and they treated erectile dysfunction in men who had failed PDE-5 inhibitors, and these were hard cases like spinal cord injury or long-standing diabetes or vascular disease all the way up to the iliac.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So these were hard cases, and they showed statistical improvement of men being able to then achieve erectile function adequate to have sex while still on the PDE-5 inhibitors.<\/span><\/p>\n<p class=\"c2\">They didn\u2019t get to throw them away, but, and this was the, these studies are the studies that led to our\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/priapustoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333948586&amp;usg=AOvVaw0yiuuto9BZ8rvK9AXryj4D\" target=\"_blank\" rel=\"noopener\">Priapus Toxin\u00ae procedure<\/a><\/span>, and that led to indirectly developing the\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/clitoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333948685&amp;usg=AOvVaw12nfz0GdTaJNuE0rB2gU4O\" target=\"_blank\" rel=\"noopener\">Clitoxin\u00ae procedure<\/a><\/span><span class=\"c0\">, because once you dive into this research, there\u2019s only one paper, and it was alluded to last week when John Leonardo was talking about his techniques of combining platelet-rich plasma with botulinum toxin with filler, and he talked about the botulinum toxin being helpful for the shy penis or the innie instead of the outie.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It\u2019s the penis that goes away in the cold water versus the guy that walks proudly on the bank of the creek, because his doesn\u2019t. And one of those papers referred to the idea that the flaccid penis was bigger, which implied perhaps a change in the autonomic nervous system, so I won\u2019t get too much into that right now.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">We\u2019ve been talking about this now for a number of years, but we haven\u2019t had a really good meta-analysis, so this is really helpful to us, and it\u2019s one that\u2019s worth referring to if you want to send out an email to your patients.<\/span><\/p>\n<p class=\"c2\">I\u2019m going to copy this and put it in the chat box right now, so you\u2019ll have it, and that\u2019s one you could link to and say, hey, this is why we\u2019re now adding botulinum toxin to our\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/priapustoxin.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333949644&amp;usg=AOvVaw3gFCB1v1R5ERmd-s9jG0C9\" target=\"_blank\" rel=\"noopener\">P-Shot\u00ae procedure<\/a><\/span><span class=\"c0\">, and I go into the nuances of how to do that, including how to pick which botulinum toxin of the various flavors and the idea of the LD50, all that\u2019s on the Priapus Shot\u00ae membership website.<\/span><\/p>\n<p class=\"c2\">It\u2019s part of\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/priapusshot.com\/members&amp;sa=D&amp;source=editors&amp;ust=1777006333949909&amp;usg=AOvVaw0FCgiEesrW9Q_PDy-GNpzb\" target=\"_blank\" rel=\"noopener\">what you have been in that group<\/a><\/span><span class=\"c0\">, so you don\u2019t have to go figure it out. It\u2019s all in there, and I\u2019ll give you the quick version: I give you the math of how you could literally do a huge, much, much bigger amount of botulinum toxin IV push and still be safe, but it\u2019s the procedure part that I think you\u2019ll find helpful to you.<\/span><\/p>\n<p class=\"c21\"><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/cellularmedicineassociation.org\/events\/\" target=\"_blank\" rel=\"noopener\">=&gt;Next Hands-On Workshops with Live Models&lt;=<\/a><\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Premature Ejaculation and Botulinum Toxin: Statistically vs. Bedroom Significant<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">Okay, now the part of this that I always don\u2019t know what to say because I see this and I think who really cares, but if you look at the premature ejaculation research and eventually I\u2019ve started this book, I don\u2019t even know, at least a half a dozen times and then I always get pulled away by something that feels more important, but if you look at the, I\u2019ll just read you what they say in this paper because it does help by their meta-analyses putting botulinum toxin in the corpus cavernosum increases the IELT or the intravaginal ejaculatory latency time.<\/span><\/p>\n<p class=\"c21\">=&gt;<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333950936&amp;usg=AOvVaw3b4xmh0ROAKbPKbibj7DCo\" target=\"_blank\" rel=\"noopener\">\u00a0Apply for\u00a0<\/a><\/span><span class=\"c13 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333951039&amp;usg=AOvVaw3qz59BDInbz5YjV3YtqsUT\" target=\"_blank\" rel=\"noopener\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c15\">\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">How longer can you last when you are injected with BoNT in the penis?<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And it\u2019s statistically significant, but look how much it is.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It\u2019s 17 seconds!<\/span><\/p>\n<p class=\"c2\"><span class=\"c6\">I don\u2019t think that\u2019s the amount of time where you\u2019re with your lover and then you have this treatment and then the next time you\u2019re together, you can last 17 seconds longer. I don\u2019t think it\u2019s the sort of thing that she smokes an extra cigarette<\/span><span class=\"c0\">\u00a0and deletes all the phone numbers of her other boyfriends.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I don\u2019t think that, although it\u2019s statistically significant, there should be an acronym for this: Is it bedroom significant?<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">We\u2019ll just call it BS. Is it BS or not?<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And I don\u2019t think 17 seconds is.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And if you go to the premature ejaculation research, there\u2019s a lot of discussion about you have to quantify things. So, what do you call \u2018too fast\u2019?<\/span><\/p>\n<p class=\"c2\">And it usually falls somewhere around three to six minutes.<sup class=\"c5\"><a id=\"ftnt_ref2\" href=\"#ftnt2\">[2]<\/a><\/sup><\/p>\n<p class=\"c2\"><span class=\"c0\">And so adding 20 seconds to five minutes would be a statistically significant change, but I don\u2019t think a bedroom significant one. It\u2019s nice that it doesn\u2019t make it worse. And it\u2019s nice that if you\u2019re an outlier, perhaps it makes it more than that.<\/span><\/p>\n<p class=\"c2\">But to me, premature ejaculation is ejaculation before both partners have had all they want for this particular session (one of the definitions is that when both partners don\u2019t reach orgasm over 50% of the time<sup class=\"c5\"><a id=\"ftnt_ref3\" href=\"#ftnt3\">[3]<\/a><\/sup><span class=\"c0\">).<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And that might be 30 seconds today, and it might be all day long tomorrow, literally.<\/span><\/p>\n<p class=\"c2\">So I think really the research is more academic than practical when it comes to pleasure in the bedroom. And I have\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.amazon.com\/Anytime-Long-You-Want-Transmutation-ebook\/dp\/B000ZSWQZO?ref_%3Dast_author_dp_rw%26th%3D1%26psc%3D1%26dib%3DeyJ2IjoiMSJ9.Uj50GJ_mwCNVF2L3nTvPCEmoMEBdWZ9JVJ-etjmoPjbgu90xhs19yqpvV9Kx8Utz_oMpc77p1avIuMXEr6E5qyf4k4Hgo5GJuJbabvrhLp47_s6XKPV5BBsumFc-VpTDPv8XV8DIGnhNs_Jw35Nmhd6IoxtQj_1fMucskWajUQE.0xNDB4vMg239dLo794DY6RJZUbmZy-8SAx0xMg-JfVQ%26dib_tag%3DAUTHOR&amp;sa=D&amp;source=editors&amp;ust=1777006333952813&amp;usg=AOvVaw1mo0DMURt6tO3vrWp53Z1F\" target=\"_blank\" rel=\"noopener\">a system for teaching guys how to get to that level<\/a><\/span><span class=\"c0\">. And it does not include botulinum toxin and the corpus cavernosum.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So I\u2019m throwing that part out [treatment for PE], but I\u2019m showing you they have the eight studies there about BoNT for ED.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Botulinum Toxin for Eye Appearance: Lateral Lid Technique<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">Okay. The next one concerns eye appearance. And depending on where you live, this may be a thing or not. We don\u2019t have as many Asian people in our community, but we have some. And I think the Asian eye is beautiful. We\u2019re all beautiful in different ways. But for Asian, Caucasians, or any ethnicity, there are people who want their eyes to be more open, depending on what they\u2019re doing.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/botoxclass.com\" target=\"_blank\" rel=\"noopener\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2754\" src=\"https:\/\/i0.wp.com\/cellularmedicineassociation.org\/wp-content\/uploads\/2024\/09\/image2-211x300.jpg?resize=211%2C300&#038;ssl=1\" alt=\"\" width=\"211\" height=\"300\" \/><\/a><\/p>\n<p class=\"c2\"><span class=\"c0\">My most common way of using this in Caucasian women is if when they smile, their eyes become more narrow than they would want.<\/span><\/p>\n<p class=\"c2\">One of my employees has the Linda Carter look, with dark hair and hypnotically blue eyes. But when she smiles, you can\u2019t see them. So, I\u2019m not speaking out of turn. She tells us at our workshops that\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333953815&amp;usg=AOvVaw3KnnUoBQluZv1XcxlAUAm7\" target=\"_blank\" rel=\"noopener\">we do a procedure to make them more open when she\u2019s smiling<\/a><\/span><span class=\"c0\">.<\/span><\/p>\n<p class=\"c2\">Now, in this version of it, they combine the idea of injecting the procerus and corrugators and the crow\u2019s feet, of course, which all open the eye.<sup class=\"c5\"><a id=\"ftnt_ref4\" href=\"#ftnt4\">[4]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\">But the very specific thing that I teach in\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/prp-training-runels\/&amp;sa=D&amp;source=editors&amp;ust=1777006333954126&amp;usg=AOvVaw3bjAAGR9Z6TikQav92bVKU\" target=\"_blank\" rel=\"noopener\">my workshop<\/a><\/span><span class=\"c0\">\u00a0is just one injection point that\u2019s in this lateral lid, even with the lateral edge of the iris. So, there you can see the difference.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It\u2019s a more open eye, even when smiling.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">But then they do something on the upper lid that I don\u2019t normally do.<\/span><\/p>\n<p class=\"c2\">I would recommend that before you inject the upper lid, you try to do everything with just my little one or two units in the lower lid. They also have a more dilute mixture that I think risks inadvertently affecting other muscles, but they wrote a beautiful paper, and their results are amazing.<sup class=\"c5\"><a id=\"ftnt_ref5\" href=\"#ftnt5\">[5]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/workshops&amp;sa=D&amp;source=editors&amp;ust=1777006333954766&amp;usg=AOvVaw1mntsC6KnrELCtHiY7Dc4V\" target=\"_blank\" rel=\"noopener\">Next Hands-On Workshops with Charles Runels, MD<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Dermabrasion vs. Microneedling with PRP for Scarring<\/span><\/h2>\n<p class=\"c2\">I thought this was really interesting because I remember when we didn\u2019t have microneedling, we just had dermabrasion. The idea of comparing this never occurred to me. If you are looking to apply a PRP post-procedure, what\u2019s going to work better for scarring?<sup class=\"c5\"><a id=\"ftnt_ref6\" href=\"#ftnt6\">[6]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Would it be dermabrasion or microneedling? And the conclusion was they both worked about the same, but the dermabrasion had a longer recovery and with the dermabrasion, not only a longer recovery, but you have to worry about hypo, not hyper, hypopigmentation. Now with microneedling, you can get hyperpigmentation, but every case I know of that it\u2019s not even mentioned because it\u2019s transitory.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">We had one of our providers, and again, a lot of what I tell you comes from not really being smart.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It\u2019s just taking notes from all you guys. When you have almost 3,000 doctors and physician extenders telling me what you\u2019re seeing, I don\u2019t, I just have to be a good note taker. But in over 15 years, I\u2019ve only had one provider call and tell me about an unhappy patient who had hyperpigmentation after a Vampire Facial\u00ae.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">But there was one little trick about it. She was dark skinned, Indian descent, and she went to India immediately after the procedure, almost, I think it was the day after, got on the plane, and she was out in the sun a lot right after the procedure.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And when I heard back, it had been about six weeks, and the lady was unhappy. My bet is it eventually cleared up. I lost follow up with the practitioner and I\u2019m not sure, but that\u2019s the only one out of our providers have easily done over a million Vampire Facials\u00ae.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">We reached that point years ago. So, I would remember to caution people, stay out of the sun, that way they don\u2019t blame the hyperpigmentation on your procedure when a good chance it just came from the sun.<\/span><\/p>\n<p class=\"c2\">And so, like alternating things that work, so we now know that, remember, saline alone, undermining big scars with saline is a treatment that\u2019s documented in the dermatology literature.<\/p>\n<p class=\"c2\">Undermining with PRP and then microneedling, those are two things that are well documented now. And then we had that one paper that showed where they compared, split-phase study, compared microneedling and PRP with microneedling and a 5% trichloroacetic acid topically.<\/p>\n<p class=\"c2\">And that study worked better than PRP combined with microneedling. And, of course, microneedling alone helps reduce scarring.<sup class=\"c5\"><a id=\"ftnt_ref7\" href=\"#ftnt7\">[7]<\/a><\/sup>,<sup class=\"c5\"><a id=\"ftnt_ref8\" href=\"#ftnt8\">[8]<\/a><\/sup>\u00a0So, for most people with minimal scarring, maybe you just do one, two, or three\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/vampirefacial.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333956846&amp;usg=AOvVaw2zv0ZYw-_yT5k5qdbbVAF0\" target=\"_blank\" rel=\"noopener\">Vampire Facials<\/a><\/span><span class=\"c0\">\u00ae.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">But if you have someone who\u2019s truly scarred, who\u2019s going to be the most thankful and grateful and probably has already seen other people that are just microneedled without knowing what you know, that person, knowing these multiple modalities and alternating every six weeks, could be very helpful.<\/span><\/p>\n<p class=\"c2\">So, now we know if you\u2019ve got a dermabrasion machine and they\u2019re not Fitzpatrick 4 or greater, you\u2019re probably safe to go for it without the hypopigmentation problem, and then alternate that with a Vampire Facial\u00ae with PRP. Oh, do the PRP after the microdermabrasion. They did PRP with both. And then you could alternate that with microneedling using TCA (trichloroacetic acid).<sup class=\"c5\"><a id=\"ftnt_ref9\" href=\"#ftnt9\">[9]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And in all of them, you pick the ones; I ask the patient, 'Which scar do you hate the most?\u2019 And then you can undermine those with some subdermal and intradermal PRP injection. So, there\u2019s some, maybe this is out. I haven\u2019t searched. Maybe this has been out before, but it\u2019s the first paper I\u2019ve seen comparing dermabrasion with microneedling, both with PRP for scarring.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">PRP for Perimenopause and Ovarian Rejuvenation<\/span><\/h2>\n<p class=\"c2\">Let\u2019s see. I put this one in. I\u2019m not going to say much about it, but we just keep seeing these coming out. Here\u2019s another review article about using PRP to help menopausal and perimenopausal women become pregnant.<sup class=\"c5\"><a id=\"ftnt_ref10\" href=\"#ftnt10\">[10]<\/a><\/sup><span class=\"c0\">\u00a0And it\u2019s just almost becoming standard of care.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Platelet Concentration in PRP: Does It Matter?<\/span><\/h2>\n<p class=\"c2\">This one I put in here just to make the point that here\u2019s another study that showed that even where it\u2019s supposed to matter, platelet concentration did not matter when injecting the shoulder.<sup class=\"c5\"><a id=\"ftnt_ref11\" href=\"#ftnt11\">[11]<\/a><\/sup><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So there are studies showing that you need a certain number of platelets, and I usually teach it this way: you need, depending on the centrifuge and the person, about 5 times the concentration of whole blood to get optimal results when injecting joints with PRP. In this one, they took a little bit different approach.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">They just looked at studies of rotator cuff repair in platelet-rich plasma, and some had the high concentrations, others had low, and they demonstrated no difference, which of course matters, because we all know a person comes in with a little thin vein, and you have the choice of 21-gauge butterfly versus 18-gauge nail, and drawing 10 cc\u2019s versus 60 cc\u2019s, knowing that could be helpful in getting your procedure done.<\/span><\/p>\n<p class=\"c2\">Let\u2019s see. Oh, okay. Make sure I\u2019ve covered it all. This one was a review article.<sup class=\"c5\"><a id=\"ftnt_ref12\" href=\"#ftnt12\">[12]<\/a><\/sup><span class=\"c0\">\u00a0I think it\u2019s too long. It\u2019s almost like a book, a chapter of a book. There was one paper out of the chapter that was a special series that came out, and I think that probably deserves to be a whole separate meeting.<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/training&amp;sa=D&amp;source=editors&amp;ust=1777006333959454&amp;usg=AOvVaw0BHyJuaftXJ62ZrKyRjaak\" target=\"_blank\" rel=\"noopener\">Apply for Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Vibrator Recommendations Post-O-Shot\u00ae: A Clinical Framework<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">So, this was the question that came up for me this week:<\/span><\/p>\n<p class=\"c21\"><span class=\"c9 c6\">When our clinic staff got trained on the O-Shot\u00ae nearly a decade ago, there was a pink vibrator that was the Intensity that had a clitoral stimulation, an electric-like current to it that was recommended. We\u2019ve not been able to get this for several years. Are you still recommending this type of stimulation post-procedure, and if so, what device?<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So, the answer to this question:<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">First, why did she have the procedure done? I\u2019ve had the, it\u2019s the best way to say this in public, I\u2019ve had the privilege of having a number of women, a number of smart, very sexual women over the past 40-plus years teach me about their bodies, and I\u2019ve had some very experimental women.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Some of what I\u2019m about to show you comes partly from medicine, and my experience from taking care of, probably, I don\u2019t know, quite a few thousand women with sex problems, and part of it comes from very brilliant women, lesbian and heterosexual, teaching me.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So, I\u2019ve modified and going to tell you a few things that are not in the medical literature.<\/span><\/p>\n<h2 class=\"c2 subtitle\"><span class=\"c6 c18\">Pain<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">If you\u2019re treating someone with pain, and it is pain that you can reproduce by, they\u2019re in your office to get an O-Shot\u00ae, that\u2019s what we\u2019re talking about. It\u2019s pain you can reproduce by pushing or touching one of the muscles surrounding the intravaginal space.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Usually, it\u2019s the pelvic floor muscle, and you touch there, and they say, yep, that\u2019s where it hurts. You\u2019re going to do an injection, regular O-Shot\u00ae, and then inject about one cc of platelet-rich plasma into that trigger point. They might get worse for a week, then get better, and you may have to repeat it every 6 weeks, 2 or 3 times.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">The most I\u2019ve repeated it was five before it went away. In that case, you probably don\u2019t need a vibrator, and the same applies to dyspareunia from lichen sclerosis, and of course, sometimes it\u2019s from a surgical problem.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">But if lichen sclerosus or the woman\u2019s anatomy is associated with a small opening, it could be from a previous surgery or genetic.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">For example, a woman went to see a plastic surgeon who bought a very expensive energy device. I can\u2019t remember if it was laser or radiofrequency, but he didn\u2019t know what you know, and a lady came for dyspareunia, and he put his wand inside of her, and her pain got worse.<\/span><\/p>\n<p class=\"c2\">Then she went to see\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/oshot.info\/members\/directory&amp;sa=D&amp;source=editors&amp;ust=1777006333961630&amp;usg=AOvVaw0St7wioceKhXLRrVOP0AQP\" target=\"_blank\" rel=\"noopener\">one of the gynecologists in our group<\/a><\/span><span class=\"c0\">, young woman, married, and the gynecologist examined her instead of having a physician extender just wave a wand around, and talked with her, and discovered this small, petite, oriental woman was married to King Kong, and the penis was just, in the Kama Sutra, you would say you would have a rabbit married to an elephant, and so the absolutely worst thing to have done for her would have been some sort of vaginal tightening procedure with laser radiofrequency.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So our person called me about it, and she did an O-Shot\u00ae to help with healing. If you\u2019re going to make the vagina more accommodating for King Kong, it needs to be able to heal as it becomes accustomed to something bigger.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Pain vs. Anorgasmia: Different Protocols, Different Devices<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">And then, what most gynecologists would say is, \"You go buy a dilator.\"<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">This is not what I\u2019m going to recommend, though.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I think it\u2019s the best place to buy sexual toys is Amazon. If you have someone who has a family, they have neighbors, maybe they\u2019re on a first-name basis with the UPS man, you don\u2019t want the box that\u2019s labeled with something that means this is a sex toy, but if it comes with that Amazon swoop, even though the swoop looks like a penis, most people think it\u2019s a book or something.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So this would be the usual dilator that is recommended either for vaginismus, or in this case, just a woman who\u2019s married to King Kong. The thing about this is that it\u2019s dead, it\u2019s a dead probe. And when you have pain, the treatment is vibration.<\/span><\/p>\n<p class=\"c2\">So what I recommend, whether it\u2019s a stenosis from surgery, stenosis from lichen sclerosis, or just trying to enlarge the vagina of a healthy woman who just happens to not match the size of her husband, is to start with a vibrator that feels very intimidating, smaller than her husband. You get a very small one, the size of a finger.<\/p>\n<p class=\"c2\">And you tell her that she\u2019s going to use that every day, a couple of times a day inside of her vagina, these are nice, that she can kind of stretch out the vaginal wall, mostly and especially near the opening, and your O-Shot\u00ae is going to help facilitate the learning to accommodate that, then after a week or two, she gets a bigger one and a bigger one.<\/p>\n<p class=\"c2\">And so instead of graduating up to bigger and bigger dilators, she graduates up to bigger and bigger vibrators.<sup class=\"c5\"><a id=\"ftnt_ref13\" href=\"#ftnt13\">[13]<\/a><\/sup>,<sup class=\"c5\"><a id=\"ftnt_ref14\" href=\"#ftnt14\">[14]<\/a><\/sup><span class=\"c0\">,<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Now, two reasons this matters. One is that it could be pleasurable.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I don\u2019t really say much about, it\u2019s okay if she masturbates with it too, but it is, and then she eventually gets one that\u2019s the size of her husband, and now the husband\u2019s penis, of course, doesn\u2019t vibrate, but when she gets to where she can accommodate that vibrator, that\u2019s the same size of her husband, then he\u2019s going to be comfortable too.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And it could be that she goes to the local sex store and picks this out herself, or she maybe goes to one of the sex online stores and works her way up like that, but that\u2019s the way to do it. Now that\u2019s for pain.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Now, if she\u2019s anorgasmic, it\u2019s a different thing.<\/span><\/p>\n<p class=\"c2\">For anorgasmia, like these little rose things<sup class=\"c5\"><a id=\"ftnt_ref15\" href=\"#ftnt15\">[15]<\/a><\/sup>\u00a0like that, and now better, of course, would be if her husband could spend a few weeks learning her body in ways that maybe hasn\u2019t thought about learning her body, but for, and I\u2019m talking anorgasmia, not the woman who\u2019s trying to have an orgasm with her while she\u2019s involved in sexual intercourse with her husband, she just wants to have an orgasm either alone or with her husband.<sup class=\"c5\"><a id=\"ftnt_ref16\" href=\"#ftnt16\">[16]<\/a><\/sup><span class=\"c0\">\u00a0And I think these are probably the most guaranteed way for her to learn how to do that.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Either that or one of these massagers like this that are pretty intense and big, but this goes on the clitoris, not inside of her. So a magic wand is one of the name brands. So this and this, those two types for the woman with anorgasmia.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I think, with that, let\u2019s see if there are any questions, and if not, hopefully there\u2019s something you can use.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And there might be something out there that I haven\u2019t seen, but I\u2019ve spent thousands on vibrators. I\u2019ve got vibrators that are so outrageous.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">One of them looks like a, it\u2019s just, it\u2019s outrageous. And some of them cost $4,000 or $5,000 each. And when you get right down to it, though, the best are the three that I\u2019ve shown you. This one and this one for orgasm, and just a simple, gradually increasing vibrator for the inside of the vagina.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Now, of course, the unspoken thing we haven\u2019t talked about yet is that there will be some men who are jealous of a vibrator. That\u2019s a tough one. There are times when, if you\u2019re not good at it and if you can get them to do it, a family counselor or a sex therapist can be of great benefit, but that\u2019s not the question. So that\u2019s a whole different topic.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Clitoxin\u00ae: When to Add Botulinum Toxin to the O-Shot\u00ae<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">You absolutely combine the O-Shot\u00ae with Clitoxin\u00ae for anorgasmia.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">For pain, do not. I think for pain, you don\u2019t put botulinum toxin in the clitoris. You could, of course, put it in the muscles if you\u2019re treating vaginismus, but it does not go in the clitoris. We had one patient, who had dyspareunia, and her pain got worse after BoNT. And that would go along with what we think might be happening with the ganglion, with the axonal transport, and what\u2019s happening in the midbrain.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">In other words, it makes sense that if what we\u2019ve postulated is going on, then orgasm lubrication and arousal would be improved, but pain might be made worse because of the way the autonomic and the somatic nerves are innervating the vagus nerve and the midbrain and then the pain sensations.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">In other words, don\u2019t do it if it\u2019s pain, but for lubrication, don\u2019t inject the clitoris with botulinum toxin, but for lubrication and anorgasmia or decreased orgasm, absolutely add the botulinum toxin to the clitoral part of the O-Shot\u00ae, and all that\u2019s described and explained in great detail on the O-Shot\u00ae website, but do not add it to the anterior vaginal wall part.<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/training&amp;sa=D&amp;source=editors&amp;ust=1777006333966585&amp;usg=AOvVaw3bQGbN5vH_mhH2vXFkG9uC\" target=\"_blank\" rel=\"noopener\">Apply for Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">J. Paul Getty\u2019s \u201cHow to Be Rich\u201d: Lessons for Medical Practice<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">Let me cover this book, and I\u2019m going to show you something else to help you see it and how it applies to our medical practices.<\/span><\/p>\n<p class=\"c2\">So this is the book,\u00a0<span class=\"c6\">How to Be Rich<\/span>\u00a0by John Paul Getty.<sup class=\"c5\"><a id=\"ftnt_ref17\" href=\"#ftnt17\">[17]<\/a><\/sup><span class=\"c0\">\u00a0Pick it up on Amazon, for nine bucks. And I bought it when it came out in paperback when I was 26 years old.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And I\u2019ll give you one of the punchlines. He talks about how, remember he\u2019s got unlimited money, basically, but he says two things in here that were surprising and very encouraging to me as a young man. He said when he travels with businessmen, of course, he was in the oil business, so he\u2019s hanging out, and he would work the oil rig.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So he\u2019s not hanging out with people in pretty white suits, but when he traveled for business, many of his colleagues and business associates would want to go to the bars or the local dance club when they were through with business. He wanted to go to the ballet, the symphony, and see art.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So that big Getty museum, you see, when you go to Los Angeles, that was not something he just threw money at to make people think that he was into the arts.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">He was into the arts.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">My own preference is that when I go to a town, I like to figure out what the coolest bookstore is in that town. Because oftentimes you\u2019ll find books that are more local in subject, and it puts you in a space that\u2019s more inspiring than other places might be.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">For example, when I lectured in Venice, there was an old bookstore there that had books in English and Italian, and you could sit in a little nook that was hanging out over the same canal where the guys come by singing and bringing the tourists around. So that\u2019s not some sort of big ethical thing.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">It\u2019s just a preference. And the only reason for bringing that up is that you would think a guy who\u2019s a billionaire, he\u2019s writing this originally as a series of articles for Playboy magazine, that maybe that wouldn\u2019t be the way he entertains himself.<\/span><\/p>\n<p class=\"c2\">But let me show you a page where he lists his\u00a0<span class=\"c6 c23\">10 rules for becoming rich<\/span><span class=\"c0\">.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And the one of the one main ones, I think most doctors ignore. The businessman, of course, or woman should never lose sight of the central aim of all business, to produce more and better goods or provide more and better services to more people at lower cost.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">If you\u2019ve ever been to my workshop, you know that I teach a definition of a profit model that I call, that I think is critical that most people never even learn the term, but he just said in a different way, my definition of a profit model, which is a way of making and keeping more and bigger promises with fewer resources, either time or cost of goods, because usually this first part, produce more and provide better services, but the key is more better to more people.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">You've got to do it at a lower cost, and the cost would include time, cost of goods, marketing, and all of it. Most doctors are not constantly, he says, never lose sight of that. It\u2019s the central aim, because when you do that, you start to make a profit.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And then the other thing is that, another this one, I\u2019ve made this mistake before, is if you\u2019re letting other people do all the thinking about your business, even if they have good intentions, which almost everybody does, they don\u2019t know what you know and doing their best, it still may not work as well as you want.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So you have to keep your head in the game, I think, or I\u2019ve seen too many doctors find out. One of my friends found out that his, it\u2019s just so cliche, he found out that his office manager who was, he met in Bible school at his church, had stolen hundreds of thousands of dollars from him.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">He almost went bankrupt. And that\u2019s so commonly done that it\u2019s almost cliche, but you got to stay in the business, not just to keep people from stealing, but more importantly, because they don\u2019t know what you know. And if you leave it to them doing their best, it\u2019s still not, may not work so well.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And this was the last one though, really six, this one and number four, excuse me, two, basically, you have to think about profit. So the first two and six are the main ones I wanted to show you. Most doctors don\u2019t think about profit.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Sounds so simple, but if I was going to tell you the number one thing, I think that separates the doctors who make literally millions versus those who just get by or go broke, it\u2019s do they make it a point to, on a daily basis, think about how profit\u2019s being generated in their office and how to constantly do more and better with less.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">And then along with that, it comes to, down to number six, is that you\u2019re always looking for new things and new ways to make things work better.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So kind of go hand in hand. So that may not seem that revolutionary, but actually in the doctor world, I think it is. I know that when I quit the ER, I didn\u2019t have to worry about profit. I just saw patients and there was an administrator to take care of all that.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">I got paid either by the hour or by a billing code based on what I did, but the hospital's profit didn\u2019t matter to me. And then I opened a practice and I thought, if I work night and day and see patients all day long and go make rounds at night, I should have plenty of money or at least not go broke.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Wrong. I was going broke, and I floated the practice on clinical trials.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So I think with that, let\u2019s see if there\u2019s any questions and if not, hopefully there was something there you can use. I put those two links in the chat box and so hopefully you can take one of those. I\u2019ll give you an email you can send out if you want to send out the summary of this, but let\u2019s see if there\u2019s a question.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Q&amp;A: BD Insulin Syringes, 31-Gauge Needles, and Closing Remarks<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">Robin says, oh yeah, I can\u2019t find those anymore. Thank you for reminding me. I need to update the website, Robin. On the website, I recommend the BD brand insulin syringes and I can\u2019t find them. I think they quit making them.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So my staff orders some off-brand. Just make sure you get the 31-gauge, 30-unit. You can truly feel the difference between a 30 gauge and a 31 gauge.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Tremendous difference in the comfort of it. But yeah, thank you for bringing that up. I need to make sure everybody knows that. So excellent question. And I think with that, and I will put a link to where we\u2019re getting them, but you can buy them pretty commonly, different brands.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">So, my bet is that, as you can see, you just wondered about the BD brand. That happened about six months ago, give or take. All right. I think with that, we\u2019ll call it a day. Thank you very much for being here. I hope you found something that will make your life and patients\u2019 lives better.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Good night or bye-bye.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">References<\/span><\/h2>\n<p class=\"c2 c12\"><span class=\"c0\">Alghazawy, Mohamad, and Yasser Almodalal. \u201cEvaluation of Flexibility and Thickness of Cleft Lip Scars After Treatment with Microneedling Technique: A Cohort Trial.\u201d\u00a0<\/span><span class=\"c9 c6\">Dermatology Practical &amp; Conceptual<\/span><span class=\"c0\">, April 29, 2023, e2023083. https:\/\/doi.org\/10.5826\/dpc.1302a83.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">\u201cAmazon.Com<\/span><span class=\"c25 c38\">\u202f<\/span><span class=\"c0\">: Female Vaginal Dilators.\u201d Accessed April 14, 2026. https:\/\/www.amazon.com\/s?k=female+vaginal+dilators&amp;crid=JTTKDC4QZFLI&amp;sprefix=female+vaginal+dilators%2Caps%2C193&amp;ref=nb_sb_noss.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">\u201cAmazon.Com: G Spot Dildo Vibrator Adult Sex Toys - SVAKOM Waterproof Personal Massager Finger Dildos Vibrators for Women - 5 * 5 Vibrations Adult Toy Female Clitoral Stimulator for Clit Nipple (More Powerful)<\/span><span class=\"c25 c38\">\u202f<\/span><span class=\"c0\">: Health &amp; Household.\u201d Accessed April 14, 2026. https:\/\/www.amazon.com\/G-Spot-Dildo-Vibrator-Adult-Toys\/dp\/B0B1J5S4V6\/ref=sr_1_11?crid=25W02EADDDMT&amp;dib=eyJ2IjoiMSJ9.TYvt0_lwvVqSIpwTQrdRUwjAlHuUSmj1Vm2RBDkGZK5JT2HhdJxKNKyd4GQYERx23aa4GCbcpJ4HHrp3SPrLzcIgb1guqQueLg2vuhjGPnCGsWhPx612Stw8JRKiOBURCSd6xFmvhbvGZ0-Wl-KoQFAD3ez_Nd7794nlUO3-KKB1GWA5Z7yMMThwv4VpB7oaMdfJcgjshzm2Skg6EJWUsdr8eHmTbrxwmJ9eAMonkGs.ekObTeOvD3rgbGEED47WE6YCx2GQrS8jum5NGQ9j5Aw&amp;dib_tag=se&amp;keywords=female%2Bvibrators%2B-%2Bdildo%2Bsmall&amp;qid=1776191402&amp;sprefix=female%2Bvibrators%2B-%2Bdildo%2Bsmall%2Caps%2C250&amp;sr=8-11&amp;th=1.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">\u201cAmazon.Com: Sex Toys Rose Dildo Vibrator - Upgraded Adult Toys with 5 Sucking &amp; Vibrating Modes for Women Clitoral Nipple, Rose Sucker Sex Toy Clitoral G Spot Vibrators for Woman Couples Adult Sex Games<\/span><span class=\"c25 c38\">\u202f<\/span><span class=\"c0\">: Health &amp; Household.\u201d Accessed April 14, 2026. https:\/\/www.amazon.com\/Rose-Toy-Women-Stimulator-Vibrating\/dp\/B0BB1VX77W\/ref=sr_1_1?crid=3K2I43UIOW8G6&amp;dib=eyJ2IjoiMSJ9.iNCFdzsV9wnTqQHnJSZdbpWfGJYZEIR4WkRMv6pxMRKksoBMqxyJmXjo15gdcAJB1rsiLCUsMu0wPchG2RSSTRtZXK0ujKx5DzB95XHzTK6zob5-DLn3mqspI2swk7UBWvJf99gEPUZSvo-kNriAnPWoo_kdTe29GSipJWi5sm0nwIUBIaScC_ndLNO2z98pYPbonkj95pzONLaPF1Y2OldZkjx-4lcBRICg8i3VZ7c.M-d0fqx624trfbXY9h9Ij4FsoOFS7plnaplx1WzjEzA&amp;dib_tag=se&amp;keywords=female%2Bvibrators%2B-%2Brose&amp;qid=1776191321&amp;sprefix=female%2Bvibrators%2B-%2Brose%2Caps%2C274&amp;sr=8-1&amp;th=1.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">De Maio, Maur\u00edcio, Kiyoko Kato, Momoko Sato, et al. \u201cBotulinum Toxin Treatment Can Enlarge Eye Appearance in Asian Patients and Improves Social and Emotional Attributes.\u201d\u00a0<\/span><span class=\"c9 c6\">Toxins<\/span><span class=\"c0\">\u00a018, no. 3 (2026): 145. https:\/\/doi.org\/10.3390\/toxins18030145.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Ebrahimi, Zahra, Yousef Alimohamadi, Majid Janani, Pardis Hejazi, Mahboobeh Kamali, and Azadeh Goodarzi. \u201cPlatelet-Rich Plasma in the Treatment of Scars, to Suggest or Not to Suggest? A Systematic Review and Meta-Analysis.\u201d\u00a0<\/span><span class=\"c9 c6\">Journal of Tissue Engineering and Regenerative Medicine<\/span><span class=\"c0\">\u00a016, no. 10 (2022): 875\u201399. https:\/\/doi.org\/10.1002\/term.3338.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Getty, J. Paul.\u00a0<\/span><span class=\"c9 c6\">How to Be Rich<\/span><span class=\"c0\">. Jove Books, 1983.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Kawase, Tomoyuki, Takashi Ushiki, and Tomoharu Mochizuki. \u201cSpecial Issue \u2018Recent Progress in Regenerative Therapy Using Blood-Derived Biomaterials.\u2019\u201d\u00a0<\/span><span class=\"c9 c6\">International Journal of Molecular Sciences<\/span><span class=\"c0\">\u00a027, no. 7 (2026): 3095. https:\/\/doi.org\/10.3390\/ijms27073095.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Lim, Joseph J., Emilea A. Stepaniuk, John W. Belk, et al. \u201cPlatelet Concentration Does Not Influence Clinical Efficacy and Retear Rates of Rotator Cuff Repair With Platelet-Rich Plasma: A Systematic Review and Meta-Analysis With Meta-Regression.\u201d\u00a0<\/span><span class=\"c9 c6\">The American Journal of Sports Medicine<\/span><span class=\"c0\">, April 7, 2026, 03635465261434001. https:\/\/doi.org\/10.1177\/03635465261434001.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Multescu, Razvan, Octav Ginghina, Bogdan Geavlete, et al. \u201cCurrent Status and Future Perspectives in the Management of Premature Ejaculation \u2013 A Review of the Literature.\u201d\u00a0<\/span><span class=\"c6 c9\">Farmacia<\/span><span class=\"c0\">\u00a064, no. 1 (2016).<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Parnham, Arie, and Ege Can Serefoglu. \u201cClassification and Definition of Premature Ejaculation.\u201d\u00a0<\/span><span class=\"c9 c6\">Translational Andrology and Urology<\/span><span class=\"c0\">\u00a05, no. 4 (2016): 416\u201323. https:\/\/doi.org\/10.21037\/tau.2016.05.16.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Saadawi, Badr, Abdulmajeed Alghamdi, Alaa Abdulrahman Ismail, et al. \u201cEfficacy of Botulinum Toxin Injections for Erectile Dysfunction and Premature Ejaculation: A Meta-Analysis of Randomized Controlled Trials.\u201d\u00a0<\/span><span class=\"c9 c6\">Current Drug Research Reviews<\/span><span class=\"c0\">\u00a018 (March 2026). https:\/\/doi.org\/10.2174\/0125899775434881260214052930.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Solanki, Bhawna, Vineet Relhan, Bijaylaxmi Sahoo, Rashmi Sarkar, and Priya Choudhary. \u201cMicroneedling in Combination With 15% Trichloroacetic Acid Peel Versus 25% Pyruvic Acid Peel in the Treatment of Acne Scars.\u201d\u00a0<\/span><span class=\"c9 c6\">Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]<\/span><span class=\"c0\">\u00a049, no. 2 (2023): 155\u201360. https:\/\/doi.org\/10.1097\/DSS.0000000000003670.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Thomas, Noble Parappattu, Shubha Lakshmi, K. S. N. Shiva Bharani, et al. \u201cComparative Evaluation of the Effectiveness of Dermabrasion and Micro-Needling Therapy in the Management of Facial Scars\u2014a Clinical Study.\u201d\u00a0<\/span><span class=\"c9 c6\">Journal of Maxillofacial and Oral Surgery<\/span><span class=\"c0\">\u00a025, no. 2 (2026): 624\u201333. https:\/\/doi.org\/10.1007\/s12663-025-02783-y.<\/span><\/p>\n<p class=\"c2 c12\"><span class=\"c0\">Wang, Xinyi, Hongyi Wei, Xi Du, Haojie He, and Caihong Ma. \u201cIntraovarian Platelet-Rich Plasma for Women with Diminished Ovarian Reserve: A Systematic Review and Meta-Analysis.\u201d\u00a0<\/span><span class=\"c9 c6\">Journal of Clinical Medicine<\/span><span class=\"c0\">\u00a015, no. 7 (2026): 2482. https:\/\/doi.org\/10.3390\/jcm15072482.<\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Tags<\/span><\/h2>\n<p class=\"c2\"><span class=\"c0\">PRP, platelet-rich plasma, O-Shot, Orchid Shot, Clitoxin, botulinum toxin, erectile dysfunction, Priapus Toxin, P-Shot, Priapus Shot, premature ejaculation, IELT, intravaginal ejaculatory latency time, PDE-5 inhibitors, autonomic nervous system, sympathetic nervous system, penis, flaccid, anorgasmia, vibrator, dilator, vaginismus, dyspareunia, lichen sclerosis, pelvic floor, trigger point injection, sexual dysfunction, female sexual dysfunction, eye appearance, lateral canthal, ptosis, procerus, corrugators, crow\u2019s feet, eye opening, blepharoplasty alternative, dermabrasion, microneedling, Vampire Facial, scarring, acne scarring, hyperpigmentation, hypopigmentation, Fitzpatrick scale, trichloroacetic acid, TCA, PRP for fertility, perimenopause, ovarian rejuvenation, rotator cuff, platelet concentration, BD insulin syringes, 31-gauge needle, gauge needle comparison, profit model, J.<\/span><\/p>\n<p class=\"c2\"><span class=\"c0\">Paul Getty, How to Be Rich, business of medicine, medical practice management, physician financial literacy, CMA, Cellular Medicine Association, Charles Runels MD, journal club, JCPM<\/span><\/p>\n<p class=\"c2\"><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/acrobat.adobe.com\/id\/urn:aaid:sc:US:bf4a1bbd-ce92-4d8f-a909-47a7d2395a0d&amp;sa=D&amp;source=editors&amp;ust=1777006333977508&amp;usg=AOvVaw18k-IRQKWhQBx95dmjc5lu\" target=\"_blank\" rel=\"noopener\">=&gt;Benefits of the Cellular Medicine Association&lt;=<\/a><\/span><\/p>\n<h2 class=\"c11\"><span class=\"c7\">Helpful Links<\/span><\/h2>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/cellularmedicineassociation.org\/events\/\" target=\"_blank\" rel=\"noopener\">Next Hands-On Workshops with Live Model<\/a><\/span><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/cellularmedicineassociation.org\/events\/\" target=\"_blank\" rel=\"noopener\">s<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<p class=\"c2\"><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/prp-training-runels\/&amp;sa=D&amp;source=editors&amp;ust=1777006333977931&amp;usg=AOvVaw0LXijwHt7jnq4xp5-4iMVy\" target=\"_blank\" rel=\"noopener\">=&gt;Next Hands-On Training with Live Models with Dr. Runels (includes marketing)&lt;=<\/a><\/span><\/p>\n<p class=\"c2\"><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/workshop&amp;sa=D&amp;source=editors&amp;ust=1777006333978069&amp;usg=AOvVaw0vqPAabxGobTGtkv_gDr4H\" target=\"_blank\" rel=\"noopener\">=&gt;Hands On Botulinum Toxin Workshop That Teaches Medical &amp; Cosmetic Uses&lt;=<\/a><\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978158&amp;usg=AOvVaw1otnNS6i23k3kz-wRVbO7g\" target=\"_blank\" rel=\"noopener\">Dr. Runels Online\u00a0<\/a><\/span><span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/botoxclass.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978212&amp;usg=AOvVaw34_D22WqnZdMEBJflzBRk8\" target=\"_blank\" rel=\"noopener\">Botulinum Blastoff Course<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978330&amp;usg=AOvVaw2tjBsT9Ob-sU-bu_SQD_Yc\" target=\"_blank\" rel=\"noopener\">The Cellular Medicine Association (who we are<\/a><\/span><span class=\"c15\">)\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978440&amp;usg=AOvVaw1ta5aOu3MAXiDyhDVkvwBr\" target=\"_blank\" rel=\"noopener\">\u00a0Apply for\u00a0<\/a><\/span><span class=\"c3 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/procedures\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978520&amp;usg=AOvVaw3a6SJQKeJ93Xm9_F6CBAtm\" target=\"_blank\" rel=\"noopener\">Online Training for Multiple PRP Procedures<\/a><\/span><span class=\"c15\">\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/oshot.info\/fsfi-calculator&amp;sa=D&amp;source=editors&amp;ust=1777006333978644&amp;usg=AOvVaw141ZmbrZ7nX252g4cAyr86\" target=\"_blank\" rel=\"noopener\">FSFI Online Administrator and Calculator<\/a><\/span><span class=\"c0\">\u00a0&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/5notes.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978744&amp;usg=AOvVaw2_DuDsoA8zuesoje6i0XZP\" target=\"_blank\" rel=\"noopener\">5-Notes Expert System for Doctors<\/a><\/span><span class=\"c15\">\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978845&amp;usg=AOvVaw2DjRHg80-MP2r_O5tdlhmm\" target=\"_blank\" rel=\"noopener\">\u00a0Help with\u00a0<\/a><\/span><span class=\"c13 c6\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978914&amp;usg=AOvVaw034WcrcJchgSO28qVHWbI2\" target=\"_blank\" rel=\"noopener\">Logging into Membership Website<\/a><\/span><span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/password\/&amp;sa=D&amp;source=editors&amp;ust=1777006333978957&amp;usg=AOvVaw1BNqtAkuFART_Zp_6Iboq5\" target=\"_blank\" rel=\"noopener\">s<\/a><\/span><span class=\"c15\">\u00a0<\/span><span class=\"c0\">&lt;=<\/span><\/p>\n<p class=\"c2\">=&gt;\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/ontraport.com\/Cellular-Medicine-Association-&amp;sa=D&amp;source=editors&amp;ust=1777006333979119&amp;usg=AOvVaw2hxFV2jTbbhRmeVodA5X-N\" target=\"_blank\" rel=\"noopener\">The software I use to send emails: ONTRAPORT (free trial)<\/a><\/span><span class=\"c15 c39\">\u00a0<\/span><span class=\"c31\">&lt;=<\/span><span class=\"c0\">\u00a0<\/span><\/p>\n<p class=\"c2\">=&gt; Sell O-Shot\u00ae products: You make 10% with links you place; shipped by the manufacturer),\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/www.loom.com\/share\/dcd9fe2284a746a199fd7d5cc42d5f61?sid%3Df5a33b4b-a3ee-4fb1-b13e-2273718dce9b&amp;sa=D&amp;source=editors&amp;ust=1777006333979333&amp;usg=AOvVaw0LvpME2KcrWxhbWOOx8ew3\" target=\"_blank\" rel=\"noopener\">this explains<\/a><\/span>\u00a0and\u00a0<span class=\"c13\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/oshotwomen.leaddyno.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333979412&amp;usg=AOvVaw1UOpiOMapxWJ68RYbQSaan\" target=\"_blank\" rel=\"noopener\">here\u2019s where to apply<\/a><\/span><\/p>\n<div>\n<table class=\"c8\">\n<tbody>\n<tr class=\"c26\">\n<td class=\"c44\" colspan=\"1\" rowspan=\"1\">\n<p class=\"c2\"><span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/runels.com\/&amp;sa=D&amp;source=editors&amp;ust=1777006333982250&amp;usg=AOvVaw1Uh0qgve00O4orIr3RQNr7\" target=\"_blank\" rel=\"noopener\">Charles Runels, MD<\/a><\/span>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0888-920-5311 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<span class=\"c3\"><a class=\"c4\" href=\"https:\/\/www.google.com\/url?q=https:\/\/cellularmedicineassociation.org\/&amp;sa=D&amp;source=editors&amp;ust=1777006333982369&amp;usg=AOvVaw3Br393y6TGSKd2N9tNyrLK\" target=\"_blank\" rel=\"noopener\">CellularMedicineAssociation.org<\/a><\/span><\/p>\n<\/td>\n<td class=\"c37\" colspan=\"1\" rowspan=\"1\">\n<p class=\"c29\">Page\u00a0\u00a0of<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"c2 c27\">\n<\/div>\n<hr class=\"c41\" \/>\n<div>\n<p class=\"c2\"><a id=\"ftnt1\" href=\"#ftnt_ref1\">[1]<\/a><span class=\"c1\">\u00a0Saadawi et al., \u201cEfficacy of Botulinum Toxin Injections for Erectile Dysfunction and Premature Ejaculation.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt2\" href=\"#ftnt_ref2\">[2]<\/a><span class=\"c1\">\u00a0Multescu et al., \u201cCurrent Status and Future Perspectives in the Management of Premature Ejaculation \u2013 A Review of the Literature.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt3\" href=\"#ftnt_ref3\">[3]<\/a><span class=\"c1\">\u00a0Parnham and Serefoglu, \u201cClassification and Definition of Premature Ejaculation.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt4\" href=\"#ftnt_ref4\">[4]<\/a><span class=\"c1\">\u00a0De Maio et al., \u201cBotulinum Toxin Treatment Can Enlarge Eye Appearance in Asian Patients and Improves Social and Emotional Attributes.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt5\" href=\"#ftnt_ref5\">[5]<\/a><span class=\"c1\">\u00a0De Maio et al., \u201cBotulinum Toxin Treatment Can Enlarge Eye Appearance in Asian Patients and Improves Social and Emotional Attributes.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt6\" href=\"#ftnt_ref6\">[6]<\/a><span class=\"c1\">\u00a0Thomas et al., \u201cComparative Evaluation of the Effectiveness of Dermabrasion and Micro-Needling Therapy in the Management of Facial Scars\u2014a Clinical Study.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt7\" href=\"#ftnt_ref7\">[7]<\/a><span class=\"c1\">\u00a0Alghazawy and Almodalal, \u201cEvaluation of Flexibility and Thickness of Cleft Lip Scars After Treatment with Microneedling Technique.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt8\" href=\"#ftnt_ref8\">[8]<\/a><span class=\"c1\">\u00a0Ebrahimi et al., \u201cPlatelet-Rich Plasma in the Treatment of Scars, to Suggest or Not to Suggest?\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt9\" href=\"#ftnt_ref9\">[9]<\/a><span class=\"c1\">\u00a0Solanki et al., \u201cMicroneedling in Combination With 15% Trichloroacetic Acid Peel Versus 25% Pyruvic Acid Peel in the Treatment of Acne Scars.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt10\" href=\"#ftnt_ref10\">[10]<\/a><span class=\"c1\">\u00a0Wang et al., \u201cIntraovarian Platelet-Rich Plasma for Women with Diminished Ovarian Reserve.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt11\" href=\"#ftnt_ref11\">[11]<\/a><span class=\"c1\">\u00a0Lim et al., \u201cPlatelet Concentration Does Not Influence Clinical Efficacy and Retear Rates of Rotator Cuff Repair With Platelet-Rich Plasma.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt12\" href=\"#ftnt_ref12\">[12]<\/a><span class=\"c1\">\u00a0Kawase et al., \u201cSpecial Issue \u2018Recent Progress in Regenerative Therapy Using Blood-Derived Biomaterials.\u2019\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt13\" href=\"#ftnt_ref13\">[13]<\/a><span class=\"c1\">\u00a0\u201cAmazon.Com\u202f: Female Vaginal Dilators.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt14\" href=\"#ftnt_ref14\">[14]<\/a><span class=\"c1\">\u00a0\u201cAmazon.Com: G Spot Dildo Vibrator Adult Sex Toys - SVAKOM Waterproof Personal Massager Finger Dildos Vibrators for Women - 5 * 5 Vibrations Adult Toy Female Clitoral Stimulator for Clit Nipple (More Powerful)\u202f: Health &amp; Household.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt15\" href=\"#ftnt_ref15\">[15]<\/a><span class=\"c1\">\u00a0\u201cAmazon.Com: Sex Toys Rose Dildo Vibrator - Upgraded Adult Toys with 5 Sucking &amp; Vibrating Modes for Women Clitoral Nipple, Rose Sucker Sex Toy Clitoral G Spot Vibrators for Woman Couples Adult Sex Games\u202f: Health &amp; Household.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt16\" href=\"#ftnt_ref16\">[16]<\/a><span class=\"c1\">\u00a0\u201cAmazon.Com: Sex Toys Rose Dildo Vibrator - Upgraded Adult Toys with 5 Sucking &amp; Vibrating Modes for Women Clitoral Nipple, Rose Sucker Sex Toy Clitoral G Spot Vibrators for Woman Couples Adult Sex Games\u202f: Health &amp; Household.\u201d<\/span><\/p>\n<\/div>\n<div>\n<p class=\"c2\"><a id=\"ftnt17\" href=\"#ftnt_ref17\">[17]<\/a><span class=\"c1\">\u00a0Getty,\u00a0<\/span><span class=\"c31 c6 c35\">How to Be Rich<\/span><span class=\"c1\">.<\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Journal Club with Pearls &amp; Marketing 2026.04.14 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0Cellular Medicine Association JCPM2026.04.14 The following is an edited transcript of the\u00a0Journal Club with Pearls &amp; Marketing\u00a0(JCPM) of April 14, 2026, with Charles Runels, MD. \u00a0 &gt;-&gt; The PDF of this live journal club can be seen here &lt;-&lt; Topics [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[137],"tags":[],"class_list":["post-1761","post","type-post","status-publish","format-standard","hentry","category-journal-club"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p8UnjI-sp","jetpack-related-posts":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/posts\/1761","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/comments?post=1761"}],"version-history":[{"count":0,"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/posts\/1761\/revisions"}],"wp:attachment":[{"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/media?parent=1761"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/categories?post=1761"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vampirebreastlift.com\/members\/wp-json\/wp\/v2\/tags?post=1761"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}