A social media trend is prompting men to inject fluids directly into their testicles in an attempt to increase their size, and emergency physicians say the practice carries consequences that can be permanent.
The trend, known as ballmaxxing, involves injecting substances like saline or a surgical lubricant called Surgilube into the scrotum. According to reporting by Healthline, some participants have inflated their testicles to the size of grapefruits. Proponents claim the practice makes them feel more masculine, boosts confidence, improves sexual performance, or makes them more attractive to partners.
Neither saline nor Surgilube was designed for this purpose. Saline is a sterile solution of sodium chloride and water used in medical settings. Surgilube is a water-soluble lubricant intended to help insert medical instruments, catheters, and endoscopes. Both are meant for external use or clinical application under medical supervision.
Robert Glatter, an attending physician in the Department of Emergency Medicine at Lenox Hill Hospital in New York City and an assistant professor at Zucker School of Medicine at Hofstra/Northwell, described the physical risks in plain terms. "The scrotum was not built for this," Glatter told Healthline. "The area is extremely sensitive and contains delicate structures — including the testicles, blood vessels, and nerves — that are simply not designed to accommodate fluid distension."
The risks Glatter identified include infection, abscess formation, and cellulitis, which is a bacterial skin infection. Pressure from injected fluid can also restrict blood flow and interfere with how the testicles function. "The very organs someone is trying to 'enhance' can be permanently damaged in the process," he said.
The setting in which ballmaxxing typically happens makes those risks worse. Most participants do it at home using kits purchased online, without a sterile environment or trained medical personnel present. Some obtain materials from unofficial sources that may contain toxic or unsterile substances. Glatter warned that sepsis, a life-threatening response to infection, is a potential outcome in those cases. Emergency surgery has also been reported as a consequence in some instances.
"Physicians have called ballmaxxing one of the most reckless body modification trends to emerge from male online communities, warning that the temporary size increase often leads to permanent damage," Glatter said.
The trend fits into a broader pattern of online maxxing culture, where social media users pursue extreme physical modifications labeled with the suffix "maxxing." Other variants have included looksmaxxing, fibermaxxing, and sleepmaxxing. Unlike those trends, ballmaxxing involves an invasive procedure with documented potential for serious medical harm, and no clinical evidence supports any of the benefits its proponents claim.
