TOPIC: Dr Rupeka - New Website

Do you find squishiness of HA's an issue regardless of filler quantity? In other words: of those who elect modest amounts of HA-filler of a higher Gprime (such as Volux or other) combined with targeted Deeper Plane injection.... that the squishness still prevails? Simply unavoidable?

I think that HA is still just more squishy no matter what. If you took the highest G prime filler (Restylane Lyft) that has a G prime of about 500 and compared it to Bellafill which has a G prime of about 2,400, it’s not even a comparison. That being said, if you put the HA in a deeper plane, it should be less squishy than if it was placed superficially. I just think that most injectors are injecting the HA in that superficial plane and it is very squishy.

@DrRupeka when are you typically in the Sarasota office?

Through the end of the year, I am going to be there 3-5 days per month. Next month, I will be seeing patients there the 24th, 25th, and 26th. I’m not sure past December, but if you want to book with me in Florida, you can discuss my days with Christina at 330-979-2126 or This email address is being protected from spambots. You need JavaScript enabled to view it.

I have only had HA, but I’m seriously considering PMMA. In most cases is PMMA going to have some iirregularities in both the Flaccid and Erect state. Or with two or three treatments can it be smooth, look and feel natural while Flaccid and Erect?

As a generality, the PMMA will have more structure to it when it is settling because the bovine collagen gel will become somewhat dehydrated and the product itself is going to cause an inflammatory response (which is usually more firm…like initially with inflammation after a surgical procedure). But, over time, as your body metabolizes the bovine collagen gel, the product itself will soften up and end up more smooth. I think that because I place my product in a deeper plane that more other providers, my results look and feel more natural while Flaccid and Erect. If, along the way, there are any irregularities that are bothering you, they are always adjustable with either diluted steroid solutions or diluted 5FU (or a combination of).

Dr Rupeka do you know if 30% PMMA will be offered eventually in the US? Would this be considered a more "firm" option? Also i saw your response regarding G Prime - what would be the G Prime of something like Alloderm or Megaderm vs PMMA? @Dr_Rupeka

Hi, I'm not sure. Bellafill is 20% PMMA and I don't really know of any other PMMA trying to get into the US aside from Ellanse and I'm not really familiar with that. I have never heard of the two that you referenced. Sorry

Im from sarasota im getting a procedure done which is all in the front in mexico if i want to do a underside procedure with you how long do i have to wait my procedure is july 17th but i know you will be in Sarasota july 25th

I'm not sure, I guess it depends on how you have the procedure done. A lot of providers inject a lot more superficial than I do, so my technique places the product in a different area, so their injections don't matter. The, sort of, problem with this is that I cannot necessarily "correct" or even out the superficial filler.

I figured since i want to do all underside work with you it shouldn't matter do you think i can see you and then you decide if you can do it when your here?

from the sound of it, the bovine collagen takes so long to break down that the microspheres are going to take a while to be encapsulated.
how would this affect the timing of anything that we might take in order to augment or assist the collagen formation?
for example, a number of men's health clinics will prescribe oxandrolone for men going into significant caloric deficit and wanting to retain muscle mass; others on here have discussed it with regards to collagen stimulating fillers. when it comes to cellulose-based carriers that dissipate fairly rapidly timing a run of oxandrolone is fairly straightforward. obviously this is not something that you want to be on for 6 to 9 months, so trying to time it for the most positive synergistic effect with Bellafill Is less straightforward to my dumb ass. I can say it for me personally that because I have been running 800 to 1,000 calorie deficit, my endocrinologist wants me on it until I'm under a specific weight and can add back more calories/carbs.

for the sake of making it less controversial, replace the oxandrolone with collagen peptides, vitamin C. etc, holistic stuff.

if we're picking a 10 week window to emphasize supportive therapies, is there an ideal timing? or I should say if there is a hypothetical benefit at all, what would be the window where it would be most pronounced?

I understand you inject deeper than most other providers, but in your honest opinion do circ men get better results than uncut with your technique or is the result the same for both? Im uncut and am finding it hard to give in to Circumcision. Ty

Hi Doctor. I'm planning a bit of a roadtrip from the west coast of Canada to east coast and hoping to pop over to Ohio on our travels. I'm wondering how far in advance usually do patients need to book to get an appointment with you?

Hi, I have blockers in place for my penis appointments because most of my patients are from out of state/out of the country, so we are usually able to accommodate you. I would say that you would maybe want to just give us a couple weeks to be safe, but I can usually make anything work (as long as I’m in town). Christina’s number is 330-979-2126. You can just touch base with her when you know your schedule or message us at This email address is being protected from spambots. You need JavaScript enabled to view it..