TOPIC: Dr Rupeka - New Website

Hi, in regard to circ vs uncirc. With my deeper technique, the skin doesn’t matter because the product gets locked under the layer that is under the skin on the shaft. The product doesn’t get affected by Circumcision, so I guess it really doesn’t matter either way. The space that I create/inject into is usually closed/fused prior to the glans. When guys get Circumcised, the Circumcision scar is generally around the same area coincidentally. If they get Circumcised lower, then usually the Circumcision will close the space and the two will coincide.

Hi, I’m not sure how to answer this. I guess in terms of the PMMA production, the body will start to “attack” the PMMA microspheres after injection. It takes our body about 6 weeks for the fibroblasts to start to make collagen fibers and about 12-15 weeks for those collagen fibers to begin to create a network or scaffolding. After that, it will continue to grow that scaffolding. The ionic charge on the PMMA molecules probably dissipates around 25 months. So, I guess that if you wanted to stimulate the collagen growth during the time where it would probably be the most active already, I would estimate that to be starting somewhere in between week 6 to week 12. Hope that makes sense. We continue to research and look up supplements, peptides, etc to help stimulate the collagen production. As of right now, I still think that PRP probably makes the most sense.

I think that makes sense, the fibroblast response is immediate, They will have no issues getting through the bovine collagen carrier and encapsulating the PMMA microspheres. My understanding of your explanation is that this is immediate, but it takes about 6 weeks for them to start building the collagen scaffold.

so if you have a 10-week supply of a peptide (IGF-1 LR3 straight to the wiener!) or an anabolic or whatever other hypothetical miracle cure that aids in collagen production, and you want to maximize your return on investment, start taking it around week 4, which means you stop at around week 14 post injection.

I guess my other takeaway is that if the fibroblasts are able to traverse the bovine collagen carrier, or any other carrier,, then the timeline for collagen production is the same regardless, the difference being with a bovine collagen carrier. you have a volume gain from the carrier itself initially. meaning the speed at which the carrier dissipates is wholly irrelevant to the timeline of collagen production. whatever the carrier, fibroblasts happen immediately, collagen production starts at around 6 weeks.

how much this makes a difference in reality I don't know. but I think most dudes are going to try to squeeze every fraction of an Inch that they can out of their procedures.

Do you inject above the Circumcision scar? I had PMMA with Avanti Derma and they injected there, but there is an area with a void there. Does your technique allow you to inject there?

Also, Avanti Derma has someone who is able to help shape and mold the product for a few days post op but I haven't read about anything like that for your clinic. Do you think that isn't necessary?

@Dr_Rupeka

Hope all is well.

I've seen others ask before but just wanted to triple check.. you perform injections on the underside correct? I'm ending my injection journey and am looking into evening out the bottom if that's at all possible

Thanks!

Hey, yes, I have gained that reputation…which is great! Lol. I did two guys at the end of last week that were sort of completing their injection journey and I just injected their undersides. We always just talk about any uneven areas or areas to target before I inject you!

So, for my normal injection technique, I inject in a deeper plane that usually ends around where the circumcision scar is. In guys that are circumcised, the circumcision scar will fuse that plane closed, so my injections sill sort of “stop” there. Yes, I inject past that often, but I will be more superficial.

Because I see a lot of guys that have had product placed prior, I will generally just inject into the same plane as what they have previous. It evens out any irregularities better this way. So, the answer to your original question is “yes”.

I do not have anyone that “molds” the product after I do it while I’m injecting you. My patients just follow the aftercare instructions and are going to be molding that themselves. I have had patients that have stayed around my office for several days after and if you wanted to come in for my PA to check on things, try to mold, etc. we could definitely do that. We are pretty easy to work with

Do you also remove small modules? And how to determine which package to get? Since I had 2 rounds with avanti, and wanting to even out , and add underside, and near Circumcision which I hope stop Turtling .

Also you recommend to get Botox before the PMMA filler treatment?

Hello @Dr_Rupeka ,

I went to Avanti Derma for 2 rounds of PMMA filler in March and August of 2024. I am happy with the results however my erection is a bit softer, most noticeably along the top of my shaft, due to the filler. In other words, there's a "pad" that feels squishy along the top. It's most noticeable when my partner has her hand around the shaft. You can see her fingers sort of sink in to the skin. While I am fully erect, this creates the sensation of a weak erection with my partner. Is there anything that can be done increase rigidity throughout the shaft?

@Dr_Rupeka do you see there a chance that a permanent enhancement option for glans ll be available soon?

(Or semi-permanent like Ellanse)

You know, I’m just not sure because that tissue just doesn’t want to expand. I would venture to say that HA would probably be the best just because it is hydrophilic and it does expand the most, but it is still a soft jelly trying to expand tight tissue.

Well, this is kinda why I have been trying to say that I think going deeper with the injections usually maintains that “hard Erection” feel. You definitely usually lose some of this with HA injections. If the PMMA was placed deeper and under the connective tissue, then it should maintain the same feel after it heals. I’m not sure what PMMA product they use, I know that some of the PMMA products outside of the US have less of a % of PMMA per unit, so maybe that has something to do with it?

Hi, yes, I have the products to help dissolve down nodules and granulomas with me at all of my subsequent appointments because I always want to even out anything if necessary every time that I see my patients. We do this with all of our injections no matter where on the body they are.

You can always select what you think you may need and, we can always adjust as needed. I always want to make sure that my patients never feel like they are wasting their money or being “sold” into doing something that they weren’t planning on or don’t really need, so we can talk through what I would recommend and how you responded in the past, etc.

Can you please elaborate on how detectable PMMA is by women? (Feel)
Is it only when Flaccid?
Is it only in the initial 4 months?

Is there a difference in feel between new shaft from lengthening vs PMMA injected area for example? lack of consistency that can be felt by a woman?

I just don’t want everyone to think that they can get injections in their penis and it will be undetectable. That is always the hope, and this does happen, but, more often than probably not, there is going to be some unevenness, possible lumps or nodules, and inevitable areas that are going to need evened out…either with patience and time or with more product, etc. I would almost error on the side of expecting this unevenness and having the expectation that this product takes a long time to settle, work, etc. I think you would be happier with the entire process that way vs expecting an increase in Girth without notice.