Men are reportedly injecting saline and surgical lubricant into their scrotums as part of a viral male beauty trend that doctors warn could cause infection, infertility, tissue death and permanent disfigurement. Known as 'ballmaxxing', the extreme body modification practice has emerged from online looksmaxxing culture, where users pursue increasingly drastic ways to alter their appearance.
The injections are intended to make the scrotum temporarily appear larger, with some participants claiming to have inflated theirs to the size of a grapefruit. However, medical specialists say neither saline nor surgical lubricant is intended for cosmetic injection, while unsupervised procedures performed at home may expose delicate genital tissue to bacteria, dangerous pressure and substances the body cannot remove.
What Is Ballmaxxing?
Despite its name, ballmaxxing does not necessarily enlarge the testicles themselves. The testicles are dense organs that produce sperm and testosterone, while the scrotum is the pouch of skin containing them. The visible enlargement associated with the trend is usually caused by fluid filling the scrotal sac rather than altering the organs inside it.
Men taking part reportedly inject normal saline or Surgilube, a water-soluble lubricant normally used to help insert catheters, scopes and other medical instruments. Saline may be absorbed by the body within approximately 24 to 48 hours, meaning users seeking to maintain the effect may repeat the injections. Surgilube presents another concern because specialists say the body cannot break it down and clear it in the same way.
University of Nebraska Medical Center urologist and men's health specialist Dr Chris Deibert said: 'Neither substance is intended for injection into the testicle or scrotum for augmentation.' He added that while the scrotum can hold fluid, 'there's no safe way to inject surgical lube or saline into your scrotum or your testicle'.
Doctors Warn of Permanent Damage
The immediate risks include severe pain, cellulitis, abscesses and infection caused by needles, contaminated equipment or unregulated products bought online. Repeated punctures may increase that danger, particularly when procedures take place without sterile equipment or a trained medical professional. Infection may then spread into the bloodstream and trigger sepsis, which can become life-threatening.
Pressure from injected fluid may also compromise blood flow to the testicle, potentially causing it to shrink or die. Other possible consequences include reduced sperm production, infertility, low testosterone, erectile dysfunction and permanent loss of testicular function. Embedded lubricant may additionally provoke chronic inflammation, foreign-body reactions and granulomas, which are localised masses of inflamed tissue.
Emergency physician Dr Robert Glatter described ballmaxxing as 'one of the most reckless body modification trends to emerge from male online communities'. He warned: 'The temporary size increase often leads to permanent damage.' In the most serious cases, patients could require surgical removal of dead or infected tissue, including partial scrotal resection.
One feared complication is necrotising fasciitis, a rare but rapidly advancing bacterial infection that destroys tissue beneath the skin. NHS guidance says bacteria can enter through wounds or injection sites, while recent research from Cambridge University Hospitals described the condition as life-threatening and capable of causing organ failure or death without urgent surgery and antibiotics.
The Dark Side of Looksmaxxing
Ballmaxxing has appeared alongside a growing catalogue of 'maxxing' trends, including looksmaxxing, sleepmaxxing and fibremaxxing. While some versions involve ordinary grooming or health habits, harder forms of looksmaxxing can promote invasive procedures based on strict ideas about attractiveness. Ballmaxxing takes that pressure into one of the body's most sensitive areas.
Participants have reportedly linked a larger scrotum with confidence, sexual performance and masculinity, although doctors say the practice offers no medical or sexual benefit. Deibert said the result is only 'a very temporary larger scrotum' and does not improve fertility, testosterone levels or sexual function.
Men concerned about testicular size, hormonal changes or possible atrophy are instead advised to consult a qualified urologist. Medical assessment may include an ultrasound and tests for testosterone, thyroid hormones and other reproductive hormones. Testicular implants are legitimate surgical options in specific circumstances, such as after cancer, trauma or removal of a testicle, but they are placed by trained specialists in sterile operating environments rather than through DIY injections.
