TOPIC: The Ditch

I’m just wondering if adding filler (PMMA) to the area between the circ scar and the glans helps with preventing or reducing retraction. I’m planning my next round and wondering if that would help or just be a waste of time and filler.

I would just do Botox. I responded very well to it and don’t retract nearly as much lately

Dickwhitman79 wrote: I would just do Botox. I responded very well to it and don’t retract nearly as much lately

Hey man thanks for that. I’ve had the Botox with 3 of my procedures and it worked okay. I dunno if I didn’t word my question right but I was wondering about adding filler between the circ scar and the glans. I currently have a kind of drop off there so I’m considering getting a little filler there. In doing that I was just curious IF that would ALSO cut down or prevent retraction from anyone that’s had filler placed there.

When I went to Avanti the last time, they put some there with my 3rd procedure. I think they use the 10% Linneasafe there to prevent nodules as opposed to the higher concentration.

That and closer to the base are the areas I had them focus on the last time.

@Dr_Rupeka what are your thoughts on this? I’m going to schedule to come back to see you in a couple of months at your Sarasota office again and am wondering if this is something worth doing.

I got the same issue. One guy in here coined the area as the shelf. See what convo comes up when you search that. From what I recall it’s not really solvable unless you correct the Circumcision or try to add filler there and be at higher risk for nodules/bumps,
Or the filler just making its way down the shaft.

When I create the space that I place my filler into, I use the cannula to dissect the tissue planes apart distally toward the glans. At some point, you reach resistance and have to stop. If you force the issue, then you can push your cannula out of that plane and into the superficial space under/within the Foreskin. Sometimes this can happen inadvertently, but I try to guard against this by feel. If a patient is Circumcised, a lot of the time the Circumcision procedure will fuse together those tissue planes and it is really hard to get the cannula through that scar tissue. I think that this is what happens when you see someone say “Dr Rupeka doesn’t inject past the Circumcision scar”. It’s not that I don’t, just sometimes I can’t.

So, what do we do? Well, I wouldn’t really recommend putting straight PMMA under the Foreskin because it will just clump to it irregularly and I don’t think that you would be really happy. A lot of the time that “shelf” will regress down over time, so you can leave it and treat it like any other fibrosed or harder area…heat, gentle massage, shockwave, saline injections, diluted Kenalog injections, etc. I do inject PMMA under there, but only a hyperdiluted, much thinner version. I think HA there is also a viable option.

I think that this would be patient-specific and you would just want to make sure that you and your provider are on the same page with the product and possible risks including uneven outcome, skin involvement, etc. That Foreskin is just so thin, it’s pretty unforgiving.

**When I approach a Girth enhancement procedures, my overall goal is for a patient to get an Erection after everything is healed and be able to move the skin up and down the shaft along that connective tissue layer just like they would have been able to before the procedure. I really don’t try to place product directly under the skin unless the patient’s ask me to…and in a case like this, usually it is to even out previous filler placed in that space. I think if you injected anything under the Foreskin, you just wouldn’t want it to take away from the natural look and feel…

Hope that makes some sense lol.

Dr_Rupeka wrote: When I create the space that I place my filler into, I use the cannula to dissect the tissue planes apart distally toward the glans. At some point, you reach resistance and have to stop. If you force the issue, then you can push your cannula out of that plane and into the superficial space under/within the Foreskin. Sometimes this can happen inadvertently, but I try to guard against this by feel. If a patient is Circumcised, a lot of the time the Circumcision procedure will fuse together those tissue planes and it is really hard to get the cannula through that scar tissue. I think that this is what happens when you see someone say “Dr Rupeka doesn’t inject past the Circumcision scar”. It’s not that I don’t, just sometimes I can’t.

So, what do we do? Well, I wouldn’t really recommend putting straight PMMA under the Foreskin because it will just clump to it irregularly and I don’t think that you would be really happy. A lot of the time that “shelf” will regress down over time, so you can leave it and treat it like any other fibrosed or harder area…heat, gentle massage, shockwave, saline injections, diluted Kenalog injections, etc. I do inject PMMA under there, but only a hyperdiluted, much thinner version. I think HA there is also a viable option.

I think that this would be patient-specific and you would just want to make sure that you and your provider are on the same page with the product and possible risks including uneven outcome, skin involvement, etc. That Foreskin is just so thin, it’s pretty unforgiving.

**When I approach a Girth enhancement procedures, my overall goal is for a patient to get an Erection after everything is healed and be able to move the skin up and down the shaft along that connective tissue layer just like they would have been able to before the procedure. I really don’t try to place product directly under the skin unless the patient’s ask me to…and in a case like this, usually it is to even out previous filler placed in that space. I think if you injected anything under the Foreskin, you just wouldn’t want it to take away from the natural look and feel…

Hope that makes some sense lol.

I am Circumcised but a few folks have commented on my “uncut penis”. It’s not a bad overhang but it’s definitely there. I’ll post some pics of my specific situation. I’ll be scheduling to see you again soon in Sarasota to sculpt this thing into a masterpiece.

Hey Tmartin304. Have you thought about Dr. Leonardo?

He mainly does HA filler but there is another user on here I believe it was Justin8 that had a bunch of HA placed over his regular PMMA.

Also if you look at his results it looks pretty good in the neck area with HA because of its viscosity I guess HA filler is easier to move into that area:

leonardomedicine.com/girthuncutGallery.html

I mean it looks like this doctor is only using two injection points and filling the penis like a balloon.

I mean Dr. Rupeka could place HA there but that would be temporary. The new HA filler Radiesse is not and is almost permanent because of the added calcium component. I did ask Dr. Rupeka if Radiesse could be placed in the glans but he said no. But I don't believe Radiesse is available in the US yet.

There was another user hyping this doctor's glans enhancement, but then that's something you would have to get topped up ever 18 months or so as well:

leonardomedicine.com/glansfillerGallery.html

Btw are you still doing the red light therapy, or any pumping or extending? I feel like that was the only way to make the glans bigger since all we're doing is making the shaft bigger.

lurkin wrote: Hey Tmartin304. Have you thought about Dr. Leonardo?

He mainly does HA filler but there is another user on here I believe it was Justin8 that had a bunch of HA placed over his regular PMMA.

Also if you look at his results it looks pretty good in the neck area with HA because of its viscosity I guess HA filler is easier to move into that area:

leonardomedicine.com/girthuncutGallery.html

I mean it looks like this doctor is only using two injection points and filling the penis like a balloon.

I mean Dr. Rupeka could place HA there but that would be temporary. The new HA filler Radiesse is not and is almost permanent because of the added calcium component. I did ask Dr. Rupeka if Radiesse could be placed in the glans but he said no. But I don't believe Radiesse is available in the US yet.

There was another user hyping this doctor's glans enhancement, but then that's something you would have to get topped up ever 18 months or so as well:

leonardomedicine.com/glansfillerGallery.html

Btw are you still doing the red light therapy, or any pumping or extending? I feel like that was the only way to make the glans bigger since all we're doing is making the shaft bigger.

I’m still doing red light and some pumping. I’ve started doing regular massaging from taint to tip as well. Seems to be good for overall blood flow and flaccid hang.
I’m definitely looking for more of a permanent solution to the neck area. I wanna get this project finished at some point. I may ask Rupeka about maybe the diluted Bellafill he mentioned and see if that’s a good solution for it. I had planned on trying to schedule in the next couple of months but have decided to wait a bit and maybe go later in the year for 50-60 syringes of Bellafill.