How to tighten Your Face Without Filler / Botox (live demo)

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  • Опубліковано 11 вер 2024
  • Tighten your face without using the typical dermal fillers or botox - this way you don't have to worry about looking regrettable as you age. This technique uses Sunekos which naturally tightens your skin up but doesn't look oevrfilled or puffy as you get older because nothing's been implanted in the skin.
    Click here to get myself supervising your entire skincare for life with any of the products mentioned in the video or see me for treatment that is cosmetic, disease or longevity-related: www.drabs.clin...
    Do your research before any of these procedures and make sure the injector is experienced as there are serious complications if injected incorrectly.
    Follow me on Instagram for more:
    / doctor.abs
    Disclaimer: this video is not intended to be a substitute for medical advice, diagnosis or treatment with your healthcare professional. This is for medical educational purposes only.
    I am not sponsored by any of the companies mentioned in this video.
    Dr. Abs
    xx

КОМЕНТАРІ • 139

  • @beebee1676
    @beebee1676 2 місяці тому +49

    I've noticed so many haters & very defensive people commenting on the Dr's videos. I guess some people can't deal with the realization they've been taken for a ride by beauty companies all their lives. So many practitioners & influencers very defensive of their livelihoods right now.

    • @betzib8021
      @betzib8021 2 місяці тому +2

      @@beebee1676 I think people get resentful when someone comes out with statements that are about things people either can't get...or that they've tried and found it to be just hype

  • @DeeDee-44
    @DeeDee-44 3 місяці тому +106

    The music needs to fade out after 90 seconds, it's too distracting.

  • @KindnessInChaos
    @KindnessInChaos Місяць тому +4

    I hope they do this in New Jersey, USA. I’ve not done anything- no Botox, no filler, no procedures, not even a professional facial. I’m 42 and love my skincare routine. I would definitely consider this!!!

    • @mikejall3644
      @mikejall3644 29 днів тому +3

      Just bought 1200 sunekos to microneedl

    • @KindnessInChaos
      @KindnessInChaos 29 днів тому

      @@mikejall3644 how?

    • @EmmaDee
      @EmmaDee 21 день тому

      @@mikejall3644let me know how it works.

  • @nimck-y2z
    @nimck-y2z 2 місяці тому +7

    Are the results from Sunekos 'Permanent' in the sense that they are truly rejuvenating? Or is it something that would last for say 6 months and then all of the results you achieved from Sunekos would be essentially 'lost'?

  • @user-ey9gc9uw3k
    @user-ey9gc9uw3k Місяць тому +3

    Please make videos without music..it's getting hard to concentrate on what you are saying...no hate though..love your videos...

  • @hannahmaria4973
    @hannahmaria4973 5 місяців тому +13

    This sounds amazing! Do you by chance know how/ if having Ehlers Danlos Syndrome would affect the results of a Sunekos treatment ?

    • @beebee1676
      @beebee1676 2 місяці тому +5

      I have EDS, i watched a seminar he did in New Zealand a few weeks ago that he posted to UA-cam. Nutakos drinkable is the supplement for (sold out everywhere) & there are patches etc for wound healing. Good luck, I'm trying it to see if it helps 😊🤞

    • @sexytechreviews_
      @sexytechreviews_ 2 місяці тому

      @@beebee1676 Fellow Zebra here. I'm a researcher, not a medical doctor. I've read the patent from 1998 that I believe resulted in Sunekos. It's titled "Reaction products of hyaluronic acid and natural amino acids and their use in cosmetic and pharmaceutical compositions." You can find it in on google. Upshot of that and other research on Springer and other med publications leads me to believe our bodies will handle it quite well. Also, Dr. Abs mentioned that Amino-Ther is a good substitute as a drinkable. I found several places that seem reputable on google to order it.

  • @valentinavrhovec1124
    @valentinavrhovec1124 2 місяці тому +1

    Stavila sam Performu prije 2 dana i wow, oduševio me kao nijedan booster do sada, imam održavanu kožu i par puta godišnje stavim neki cross linked booster i sad sam probala Performu, odmah je zategnula obraze, drugi put ćemo ispod očiju i lagano cijelo lice...

  • @Sunshinelotus22
    @Sunshinelotus22 2 місяці тому +3

    I had really bad experience with fillers and hyaluronidase. I was told they were safe. How can I trust this product?

  • @yall2743
    @yall2743 2 місяці тому +5

    In which countries does this exist? Europe?

  • @JordyJRT
    @JordyJRT Рік тому +13

    Hate to say the pic at 0:47 is 100% edited, the reflections in the eye are identical.
    Dr Abs what’re your thoughts on the new seventy hyal skin boosters from fox pharma

    • @Dr_Abs
      @Dr_Abs  Рік тому +7

      D'oh! If only you were around to tell me that before I uploaded haha. I think the seventy hyal is promoting the fact that weight is extremely important when it comes to HA. However, I think HA on its own can only yield so much. The studies on those kind of products (including profhilo) aren't long ones which tells you what you need to know. That's why I stopped using them. Sunekos can show an increase in everything for double the amount of time which tells me it's truly working with the skin to change it's behaviour for the better and for the long term. Seventy Hyal isn't bad; I just think the studies show more improvement and for longer with Sunekos. Hope that helps 😊

    • @dominusstyx
      @dominusstyx 2 місяці тому +2

      Hahaha...Yeah, you're right, so if one is fake, what about the rest? What a strange world we're living into

  • @XenonIIMB
    @XenonIIMB 7 місяців тому +8

    Sounds a lot like profhilo, what with the multiple injection sites and treatments, but unique and far better.

    • @Dr_Abs
      @Dr_Abs  7 місяців тому +6

      The histories of both companies are more entwined than you think haha

    • @doraemalone8711
      @doraemalone8711 Місяць тому +1

      How can one use Sunekos in the United States? Or even the supplement? Can you recommend a similar product?​@Dr_Abs

  • @lialandi
    @lialandi 2 місяці тому +3

    This sounds so great. I hate fillers! This is sound & natural. What do I do as this treatment is not available in the USA? Of course. Do I have to travel to you?

  • @tonyaellerby4884
    @tonyaellerby4884 3 місяці тому +6

    Hello Dr. Abs. 1.Has the protocol now changed from one 1200 treatment and 3-4 200 treatments in a series to One 1200 followed by 3-4 Performa? Also, the slide that you showed of the neck/under chin, I supposed that is for tightening. What is the protocol for that and how many treatments please and do you have a video on that? Lastly, what is the protocol for volumizing/filler effect? Let's say for volume loss in mid face and do you have a video on that please? I have looked through your channel but may have missed. Again, that you for all that you do and all that you are. Blessings

  • @user-mw1co3wk1w
    @user-mw1co3wk1w 11 місяців тому +6

    Hey Dr Just curious is Sunekos strong enough to improve the nasolabial folds ? one side of my face the fold is deeper

    • @Dr_Abs
      @Dr_Abs  11 місяців тому +4

      It can always improve the skin. But nasolabial folds are not necessarily a skin issue - a lot of the time it's the fat above the fold that's coming down due to gravity and 'folding' over other tissues. Best advice would be to have a consultation or noone will know the answer just from a comment online.

  • @slowsky74ify
    @slowsky74ify 2 місяці тому +2

    Dear Dr. abs, I always follow your videos with great attention. I convinced my aesthetic doctor to purchase Sunekos Performa which he didn't have. It will arrive in a few days and I will have it injected based on the protocol you indicated. In the
    do you use the same Performa around the eye area? it can be done on the face and around the eyes
    in a single session? How much product will be needed for both treatments? let me know, thank you in advance

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      I do use it on the eyes. I can't prescribe volumes without seeing you I'm afraid. But the manufacturer Professional Dietetics can be contacted for info

    • @slowsky74ify
      @slowsky74ify 2 місяці тому +2

      @@Dr_Abs Thank you very much for answering

  • @copetillirope178
    @copetillirope178 2 місяці тому +5

    why can't there be a patented version of the sunekos collagen amino acid producing technology but without the added HA for those afraid of migration or volume augmentation as i'm under the impression even non crossed linked ha create unwanted volume? thanks

    • @QueenBeeDigital
      @QueenBeeDigital 2 місяці тому

      No it does not. The acid is completely and easily absorbed into the body very quickly as it has no cross linking whatsoever.
      It’s always present in the skin naturally and it doesn’t cause any volume.
      Also you want this product to migrate into all surrounding tissues for optimal results or else you’d just have ‘ bumps ‘ of weird collagen where each injection was placed. The very purpose of the acid is to create enough moisture for absorption and movement.

  • @franciscoferrer278
    @franciscoferrer278 2 місяці тому +1

    How long do the effect last and how often it has to be done? What’s the cost of the treatment?

  • @gilgaralnick3666
    @gilgaralnick3666 Місяць тому

    Hi, great videos.
    I also provide Sunekos however I am trying to find what the longterm side effects of Botox and HA are
    Thanks

  • @i_am_thebatman
    @i_am_thebatman Місяць тому +1

    Really wish you had a practice in Chicago man . I feel like the only way to get it done right is to fly down to the UK and have you do it

  • @ElysiaTaylor
    @ElysiaTaylor 2 місяці тому +1

    Will this work on eye bags and a double chin? Thx❤

  • @rakheek659
    @rakheek659 2 місяці тому +2

    Is it available in India...

  • @Unflappable43
    @Unflappable43 2 місяці тому +3

    Is this available in Australia? If not could you recommend anything similar thanks 🙏

    • @Dr_Abs
      @Dr_Abs  2 місяці тому +6

      Coming hopefully this year or next for Australia

    • @chech53
      @chech53 29 днів тому

      Is it available anywhere in the US?

  • @juanitacarter8937
    @juanitacarter8937 Місяць тому +1

    I cant wait 😊

  • @ghaoisiarrthoir
    @ghaoisiarrthoir Місяць тому

    Bravo Dr Abs
    💯💪👊👍

  • @maxpesh
    @maxpesh 2 місяці тому +1

    At a 30 degree angle how many mm are you going in with the needle to reach correct depth ?

  • @ZoeMC369
    @ZoeMC369 3 місяці тому +2

    Hi there! I saw on a different video of yours, you were emphasizing injecting performa as superficially as possible, and here it seems more like 2mm depth. Just curious if your thoughts on depth have changed over time.

    • @Dr_Abs
      @Dr_Abs  3 місяці тому +1

      Depends what you're injecting

    • @ZoeMC369
      @ZoeMC369 3 місяці тому +1

      @@Dr_Abs Sunekos performa and sunekos 1200. Mid to deep dermis I thought. Not sure which product it was where you were injecting as superficial as possible.

  • @xssbest756
    @xssbest756 Рік тому +5

    Going to try this x

    • @Dr_Abs
      @Dr_Abs  Рік тому +2

      Get in touch if you need help finding the best person near you for it

    • @francesjeanlouis9285
      @francesjeanlouis9285 2 місяці тому

      Me too!👍

  • @crystalglass1358
    @crystalglass1358 2 місяці тому +1

    Is there the same possible danger of going blind with Sunekos as there is with improperly injected fillers?

  • @sorrynotsorry7949
    @sorrynotsorry7949 Рік тому +2

    I’ve had sunekos 200 in neck and décolleté , do I need more than one treatment ?

    • @Dr_Abs
      @Dr_Abs  Рік тому +2

      Yeah one session isn't enough to create physiological changes to your tissues. Also, 200 is the old formula - Performa is the one to have now. It's also extreeeemley technique sensitive so make sure where you go has someone trained properly by myself if possible.

  • @ij4456
    @ij4456 7 місяців тому +3

    But how long does it last for especially for the dark circles?

    • @Dr_Abs
      @Dr_Abs  7 місяців тому +3

      I've seen results over two yrs

    • @ij4456
      @ij4456 7 місяців тому

      @@Dr_Abs lovely but i heard from another dr that for those who have puffy eyes it makes it worse and gets Even more swollen after injecting the sunekos. Because it gets filled with water.

    • @Dr_Abs
      @Dr_Abs  7 місяців тому +2

      I'd suggest critically that they're knowledge of the product is poor and are probably inject it wrong. I've literally never had that so it can't be true. I have a theory video of it on this channel that's three hours. I'd say watching that is probs a good start for them.

  • @sukkatdavid3365
    @sukkatdavid3365 Місяць тому

    You say "without filler", but isn't his a filler too? The reason I ask is because fillers pose a danger especially around the eyes for blindess. Would sunekos not be in this danger statistic as well?

  • @Penelope-2020
    @Penelope-2020 2 місяці тому +4

    Is it available in US

    • @Dr_Abs
      @Dr_Abs  2 місяці тому +1

      Not yet unfortunately

    • @awhittick9268
      @awhittick9268 2 місяці тому +2

      ​@@Dr_Abs🙏 🙏 🙏 please bring this to CALI!! 😫😫

  • @avgonyma1
    @avgonyma1 2 місяці тому +2

    Hello doctor.
    I've been watching your videos and have a few questions:
    1. Wouldnt any injections (whatsoever) leave some kind of skin injury at the spot of the injection, leaving behind a mini scar that would then be visible/stabding out slightly , when you look at the skin from the side (not smooth, even surface)?
    2. How do these here presented effect compare to injecting the same substance into the belly fat (as mentuoned in so e other vudeos)? Can the belly injection somehow replace the local one on the face?

  • @stefanprivat5010
    @stefanprivat5010 3 місяці тому +2

    Are you treating patients and how to make an appointment with you?

    • @Dr_Abs
      @Dr_Abs  3 місяці тому +2

      In London, yes. Feel free to message me privately on Instagram @doctor.abs 😊

  • @LolkeDijkstra
    @LolkeDijkstra 2 місяці тому +1

    So, it's actually Dr. Abhinay Settipalli

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      It's my name lol

    • @LolkeDijkstra
      @LolkeDijkstra 2 місяці тому

      Abhinay Settipalli
      @doctor-abs

  • @yogawithryan8098
    @yogawithryan8098 2 місяці тому +1

    Where can you get this treatment in Texas USA ?

    • @doraemalone8711
      @doraemalone8711 Місяць тому

      I already googled and looked but couldn't find it, that's why people are asking if he has any knowledge not readily found on Google. Not lazy

  • @AmandaJohnson-eh6cj
    @AmandaJohnson-eh6cj 5 місяців тому +2

    how many treatments and how many days apart for average person please?

    • @AmandaJohnson-eh6cj
      @AmandaJohnson-eh6cj 5 місяців тому +1

      for under eye...

    • @Dr_Abs
      @Dr_Abs  5 місяців тому +3

      For tear trough region I see results after one treatment. I average about 3 as a course but I have some that finish after 1 or 2 and some that just keep going constantly beause the risk is practically 0.

    • @AmandaJohnson-eh6cj
      @AmandaJohnson-eh6cj 5 місяців тому

      what to charge for 1. Under eye treatment per session and 2. 2.3 ml SHP technique per treatment please?@@Dr_Abs

  • @tonyaellerby4884
    @tonyaellerby4884 3 місяці тому +1

    Hello again Dr. Abs, have you ever had a patient that required more than one box of the 1200 along with the Performa? Let’s say for asymmetrical facial hollowing along with standard lower face issues please?

    • @Dr_Abs
      @Dr_Abs  3 місяці тому +2

      It's not a product to treat hollowing. Nothing wrong with using more dose

    • @tonyaellerby4884
      @tonyaellerby4884 3 місяці тому +4

      @@Dr_Abs Thank you so much! Your ears and every other part of your body should be burning. I am in a couple of meso therapy groups of over 100,000 members from around the world. I wish you could see some of the posts. Everyone is lusting after and in love with you and we all watch your videos over and over. And I must say it’s not all just for your technique and knowledge! 🤣🤣❤️ PS I think in the past two weeks, we have purchased all of the available Sunekos in the UK and EU! Be well.❤️

    • @Dr_Abs
      @Dr_Abs  3 місяці тому +3

      Haha thank you for that. Let me know the group and I'll see if I can dig out my old Facebook account to reply to people if they have questions

  • @Nora-2022
    @Nora-2022 2 місяці тому

    Hey Dr. is it possible to apply the face cream by Sunekos after microneedling at home?

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      Definitely

  • @sonia_mod
    @sonia_mod 2 місяці тому

    Hi Dr. Abs, what’s your opinion on Sunekos during pregnancy/breastfeeding?

    • @toomanymarys7355
      @toomanymarys7355 2 місяці тому

      If you're pregnant or breastfeeding, you're too young for this. Retin-A, sunblock, microneedling, 30% glycolic peel, OneSkin if you've destroyed your face totally with sun damage.

    • @toomanymarys7355
      @toomanymarys7355 2 місяці тому

      Also Vit C serum, but 8+ hours apart from OneSkin

  • @travelingismypassionh7486
    @travelingismypassionh7486 2 місяці тому

    Is it available in Switzerland?

  • @Scentobsessedemma
    @Scentobsessedemma Місяць тому

    Dr Abs what are your thoughts on Redensity 1 as my Botox Dr here in Sydney says it’s better than Sunekos as it’s an older brand, has better ingredients, includes more aminos and also has minerals and antioxidants. They are supposed to be similar. I’m wondering if Redensity 1 stimulates the same number of collagen and elastin types as you say Sunekos does (hence its patents)? It’s hard to get Sunekos here so should I just do a course of Redensity 1? I hope you can reply? ☺️☺️

    • @Dr_Abs
      @Dr_Abs  Місяць тому +1

      Sounds like the doc needs some education. 'more' aminos can reduce the number of collagen types and just general effect. This is why BCAA products in bodybuilding are generally in a specific ratio. Minerals don't activate protein synthesis pathways in the mitochondria like sestrin-2. Antioxidants have levels of orac values - sunekos 1200 is the antioxidant while performa does the work. If your doc was good they'd have told you which types of collagen R1 makes but sounds like they haven't which should tell you something - if R1 was better then why is it not making the same or more collagen types? Will probably be next year that Sunekos comes to Aus

    • @Scentobsessedemma
      @Scentobsessedemma Місяць тому

      @@Dr_Abs thank you kindly for replying. I’m desperate for Sunekos I need it now 🤪🤪 Yes I thought the same which is why I’m pushing him to bring it in for me. If you ever visit Sydney Australia for a working holiday, please let me know!! ☺️☺️

    • @Dr_Abs
      @Dr_Abs  Місяць тому

      I'll be visiting when the product launches and will need models most likely so keep an eye on my Instagram

    • @EmmaDee
      @EmmaDee 21 день тому

      @@Dr_Absdoc, is this similar to sculptra?

    • @Dr_Abs
      @Dr_Abs  21 день тому

      @@EmmaDee Depends on what metrics you're comparing them, but I'd say no. Sculptra is pretty much just type 1 collagen as far as I'm aware. I made a video on it on the channel called skin tightening gone wrong or something - watch that and you'll see the scar tissue it can create according to the plastic surgeon who took a picture of it in the face.

  • @Andrea-64
    @Andrea-64 Місяць тому

    How long does it last?

  • @awhittick9268
    @awhittick9268 2 місяці тому +2

    But where can we get these injections?? I have looked for places in California and nowhere to be found 🤷‍♀️🧐

    • @yfa6244
      @yfa6244 2 місяці тому

      Not in usa yet

    • @sexytechreviews_
      @sexytechreviews_ 2 місяці тому

      @@yfa6244 FDA are pitas and want a million basically to approve it.

  • @mariuszjasinski5202
    @mariuszjasinski5202 9 місяців тому +5

    Can sunekos give the same results as sculptra?

    • @Dr_Abs
      @Dr_Abs  9 місяців тому +5

      It gives even more - sculptra essentially works on fibrosis and inflammation. Sunekos makes more important collagen for skin tightening like type 4 and 7. Check this post out to see what sculptra does to you:
      instagram.com/p/C0AR-91KcVd/?igshid=MzY1NDJmNzMyNQ==

    • @mariuszjasinski5202
      @mariuszjasinski5202 9 місяців тому +3

      I have watched all your videos and I am very grateful for them. An incredible amount of knowledge and passion. Greetings from Hamburg

    • @Dr_Abs
      @Dr_Abs  9 місяців тому +2

      Danke schön 🙏 Ich liebe Deutschland und Ich spreche auf Deutsch auch 😁 Ich werde komme um nach Deutschland ein tag

    • @mariuszjasinski5202
      @mariuszjasinski5202 9 місяців тому +2

      @@Dr_Abs Dann müssen sie unbedingt nach Hamburg kommen ist ein sehr schöner Stadt 😊

    • @Dr_Abs
      @Dr_Abs  9 місяців тому +1

      🙌🙌

  • @betzib8021
    @betzib8021 2 місяці тому +7

    Sounds nice...but no one around here has heard of it.

  • @NH-hl5eb
    @NH-hl5eb 2 місяці тому

    HOw do you find a doctor in Texas who uses SUNEKOS?

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      Email the manufacturer to ask - Google 'professional dietetics' and go to the contact page

  • @BrendaHouston_
    @BrendaHouston_ 2 місяці тому +1

    Is this in America?

    • @shars.555
      @shars.555 2 місяці тому

      Yes. Google it.

    • @TheCinderyJean
      @TheCinderyJean Місяць тому

      @@shars.555really? I can’t find anyone in California that does it. All I see are UK and European websites on Google results.

  • @letsbeforeveryoung
    @letsbeforeveryoung 2 місяці тому +19

    Stop music so annoying

  • @johnny-mnemonic13
    @johnny-mnemonic13 7 місяців тому +1

    Is this available in the USA?

    • @Dr_Abs
      @Dr_Abs  7 місяців тому +4

      Unfortunately not yet. The FDA make it so damn expensive to register a product 😂

    • @johnny-mnemonic13
      @johnny-mnemonic13 7 місяців тому +1

      @@Dr_Abs bummer.. do you have a alternative recommendation here in the states?

    • @Dr_Abs
      @Dr_Abs  7 місяців тому +2

      @@johnny-mnemonic13 I'd look at something like intofaces.com or Sciton laser devices in a clinic somewhere.

  • @seabreeze4559
    @seabreeze4559 25 днів тому

    You really need better SEO like the name of the product in the title and the 3 tag limit youtube allows. Don't be shy online. If your videos are hard to find it doesn't matter how good they are! A few anatomical visuals for skin layers might help, there are websites where you can get video graphics and some of those must be medical, as would something like tube buddy help for monitoring your metrics, a lot of youtubers do that. How often can Sunekos be done, is there an upper limit to the benefit like diminishing returns or could a rich person theoretically just keep getting it? Why isn't there a link to like a map of clinics in the UK that do it? What would be the minimum to maintain it? Does it vary by sex, age range etc.? Is numbing cream available for those of us with needle phobias? I know it isn't the same but can you comment on the Qure home microinfusion system and if it's BS? I know you'd tell the truth. Does Sunekos help with crater type scars or what specific treatments would that need? Would any lasers help that? You said elsewhere it could be used with other things but don't mention it here.

  • @QaisBhatt250
    @QaisBhatt250 Місяць тому +1

    Music in this video is like fragrance in a sunscreen 😂...too much irritating

  • @pontificusvascillious5287
    @pontificusvascillious5287 2 місяці тому +1

    you go first ...
    🥴

  • @epereomins8971
    @epereomins8971 2 місяці тому +1

    Isn't there a cream form?

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      Yeah it's called Nutrakos but it's not going to give you as significant a result as the injectable

  • @tammytaylor9383
    @tammytaylor9383 2 місяці тому

    Can we do this without being injected as I can't do injectables with needles?

    • @QueenBeeDigital
      @QueenBeeDigital 2 місяці тому

      Yeah you can use a magic wand 😅🤣🤣🤣
      Y’all are so funny in here lmfao

  • @JackLem653
    @JackLem653 2 місяці тому

    shiiiiiiit why havent i heard of this haha thank you ill try to ask the skin doctor next time...

  • @Jessica-ko1eg
    @Jessica-ko1eg 2 місяці тому

    Can it be used on the buttocks?

    • @Dr_Abs
      @Dr_Abs  2 місяці тому

      Sure, I've treated there before

  • @carolmaplesden916
    @carolmaplesden916 2 місяці тому +2

    Can't do the music
    Im out

  • @KotobukiGirl
    @KotobukiGirl 2 місяці тому

    Is it vegan?

  • @simonewright1120
    @simonewright1120 2 місяці тому +1

    🤮🤯😫

  • @laibanush5431
    @laibanush5431 2 місяці тому +1

    Stop using music please. So distracting. Gives me a headache.

    • @Dr_Abs
      @Dr_Abs  2 місяці тому +1

      I have. Try looking around before you comment perhaps.

  • @StripperPhysics
    @StripperPhysics 2 місяці тому +2

    Is this available in the USA?