Injection Plane and Depth Matter 

At Youthology, Dr Rupeka's technique Goes Deeper - for Smoother, Smarter Results

By placing the PMMA filler beneath the correct fascial plane, Dr Rupeka is able to avoid some of the more common complications seen with superficial injections. His technique will usually deliver a more natural, durable, and aesthetically superior penile enhancement result in both men that are circumcised and uncircumcised. 

Our Approach: Anatomical Precision for Every Patient

Why Deeper Plane Injections Matter: 

-The success of penile girth enhancement with injectable fillers like PMMA depends not just on the material being used, but WHERE it is placed. At Youthology, we used a highly specialized technique to place the filler beneath Colles' fascia, a stable anatomical layer that provides long-term support and a smooth, natural contour. 

-Colles' fascia is a fibrous layer beneath the superficial skin and dartos tissue. Placing PMMA filler beneath this layer provides: 

• More stable, uniform results

• Better collagen integration

• Lower risk of surface irregularities

• Greater protection against migration or lumping

• Protected against migration over time

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Why Superficial Filler Placement Often Leads to Poor Results:

-When injectable fillers like PMMA are placed too close to the skin, above the natural fascial boundary known as Colles’ fascia, the result is often aesthetically and structurally inferior.

-This is commonly referred to as superficial placement, and it’s one of the leading causes of poor outcomes in penile girth enhancement.

-Placing filler above this layer may lead to: 

• Visible nodules, rippling, or "stacking" of filler

• Migration with erection, retraction, or skin movement

• More room for the filler to clump and become irregular leading to less predictable long-term aesthetics

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Problems Associated with Superficial Filler Placement:

• Irregular Surface Texture: The superficial plane doesn’t provide enough resistance or structure to hold the filler evenly. Patients often experience visible rippling, bumps, or nodules along the skin.

• Stacking or Layering Effect: In repeated treatments, superficial placement can lead to stacked bands of filler rather than a smooth cylinder of girth enhancement. This creates unnatural ridges, especially during erection.

• Migration or Shifting: Fillers in the superficial layers are more prone to movement or pooling, particularly in areas of high skin mobility like the foreskin or circumcision scar.

• Skin Discoloration or Thinning: Because the product sits closer to the skin’s surface, it may be visible through the skin or cause localized thinning over time, especially in men with thinner dermal tissue.

• Increased Risk of Nodules: Superficial placement increases the chance of firm, visible nodules, which may require massage, steroid treatment, or even surgical correction.

Circumcised vs Uncircumcised: How Anatomy Affects Placement:

In circumcised men, the skin of the shaft is:

• Tighter and less mobile, offering less “room” for superficial filler to settle

• Under more tension during erection, which exaggerates irregularities or product bunching

• Prone to stacking at the circumcision scar if filler is not anchored in a deeper, more stable plane

• Deeper placement beneath Colles' fascia is essential here to maintain a smoother and more even result both during the flaccid state and with erections

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In uncircumcised men, the skin of the shaft is: 

• Generally more mobile and redundant, especially over the shaft and foreskin

• Easier to "fill" because there appears to be more "space", but this extra space also can lead to more shifting and pooling (especially under the foreskin if not anchored properly)

• Deeper placement beneath Colles' fascia is essential in these patients to keep the filler fixed In position BENEATH this mobile skin and avoid filler migration and possible pooling in the foreskin. Deeper placement will also promote more natural movement and appearance with erections and foreskin retraction

Our Approach: Anatomical Precision for Every Patient

Whether you are circumcised or uncircumcised, our approach is tailored to your anatomy. By placing filler under Colles’ fascia using a microcannula technique, we prioritize:

• Smoother, longer-lasting results

• Lower risk of complications

• More natural feel and function

• Optimized aesthetics in both flaccid and erect states

Proper plane = predictable, natural-looking results:

-We correct a lot of superficial placement issues from other providers — and we want you to get it right the first time.