1. Discuss risk/benefits and how the procedure fits into an overall plan of health, &/or incontinence treatment, &/or orgasm system improvement.
2. Consent form signed and added to the chart (click to see)
3. Complete:
   1. Complete FSFI & FSD surveys (click to see).
   2. Health and Lifestyle Questionnaire<–click to download
4. Topical anesthetic to the clitoris, labia (if to be treated), and anterior vaginal wall.

   The topical anesthesia that I think works best is Benzocaine, Lidocaine, Tetracaine: 20%/8%/8% from McGuff Pharmacy (877-444-1133)–ask them to use the same carrier cream used in the Vampire FaceLift® and be sure to emphasize you want 20/8/8 (not 20/4/4)!

   The cream is not as critical to the research but the pain (or lack of pain) from the procedure is part of the reputation that we are creating–so PLEASE make sure whatever cream you use works at least as well as this one (and if you find one that works better–please let us know).

   Consider pre-op with pain meds & benzodiazepine if the person needs gas when she goes to the dentist or if she will undergo extensive injection of the labia for lichen sclerosus or for rejuvenation of the labia.

5. Phlebotomy
   Click to see sources of PRP kits & other supplies (click)<–
6. Isolate PRP (wait about 15-20 minutes for the cream to be absorbed). While waiting, can finish discussions with patients and prepare as follows:
   1. 1. Fill a 1 cc syringe (Syringe A) with 1% lidocaine without epinephrine. Put a 30 gauge 1/2 inch needle on the syringe.
      2. Add 0.05 cc of 10% CaCl or calcium gluconate to a 1cc syringe with a Luer lock (Syringe B).
      3. Add 0.2 cc of 10% CaCl or calcium gluconate to a 5 cc syringe with a Luer lock (Syringe C).
      4. Put the woman in the supine position with stirrups if possible and the pelvis tilted to allow better visualization of the anterior vaginal wall. Put on a headlamp (easier for me because I don’t have to touch an adjustable exam lamp) or prepare your exam lamp.
         Here’s my favorite headlamp (click here to see on Amazon)…
7. Here’s a good basic work-horse exam table that’s been proven for over 10 years. You can use it for facial injections, P-Shots®, & O-Shots®. It’s possible to do an O-Shot® without a good exam table, but you’ll find it much easier and you can do a much better overall exam if you have a table with stirrups. (you’ll find the facial procedures easier to do if you slide the step closed while working).
8. More about the Calcium chloride…[Amount of CaCl added] = [Amount of PRP] ÷ 20
   for example–if you had 5 ml of PRP,
   5 ml PRP ÷ 20 = 0.25 ml of CaCl to be added

I usually do not use CaCl for the Vampire FaceLift® with the idea that a slow, spreading activation in the face can be a good thing.

I DO HIGHLY RECOMMEND THAT YOU USE CaCl for the O-Shot® & the Priapus Shot where a localized reaction and set up of the platelet-rich fibrin matrix is more desired.

If a drug rep tells you differently, realize that they cannot talk off label (which CaCl is for every kit except for Selphyl) and that they have very good intentions but I’ve not bet the one yet who has been teaching doctors how to do this for 11 years in 54 countries, so please just smile and move on.

Note–if you’re looking for how to treat lichen sclerosus, then goto the upcoming section to learn how to perform that protocol AFTER you’ve learned everything else on this page
(you should know how to do the basic O-Shot® procedure before treating lichen sclerosus).

9. Hold ice (or better, an assistant holds ice) for about 2 minutes, then take the ice away and block the clitoris as shown in the video by Dr. Lubin (using Syringe A).

10. Finish filling Syringe C (the 5 cc syringe) with PRP to a total of 4 cc (0.2cc of CaCl + 3.8 of PRP). Add a 27 1 & 1/4 inch needle. Be wary of using more than 4 ccs for injection (it’s tempting).
Note: In one of the how-to-do videos, I erroneously say “9.8 ml.” Obviously, can’t put 9 ccs in a 5 cc syringe 🙂 The correct amount is 0.2 cc of CaCl + 3.8 of PRP.

Here’s the Luer lock connector that works best.

Can order from McGuff Pharmacy and others (click).