Men are turning to a dangerous practice known as ‘ballmaxxing’ – inflating their scrotums with saline solution – despite stark warnings from medical professionals about the risk of infection, nerve damage and even life-threatening complications such as gangrene.
The trend, documented extensively on a Reddit community of nearly 10,000 users, involves inserting needles taped into the scrotum and administering saline drips purchased online. Participants aim to swell their testicles from the size of a plum to that of a grapefruit, sometimes so much that the penis becomes enveloped by the swollen sac. While rooted in body modification kink, the practice can be either sexual or non-sexual – but the health dangers are severe.
Why men are doing it
Sex expert Gigi Engle, author of Kink Curious, explains that ballmaxxing falls under the umbrella of body modification kink, where altering the body temporarily or permanently is done for sexual arousal or aesthetic gratification. ‘It’s linked to “freakshow” type body modification which celebrates extreme size,’ she says. ‘Things being larger than life is part of the erotic appeal.’
Users on the online community describe enjoying the weight of an inflated scrotum. One wrote: ‘It feels so good to be that heavy.’ Another reported pleasure from the sensation of his penis being ‘buried within’ his scrotum, while a third enjoyed the ‘tingling’ of the skin stretching.
The practice can also feature in BDSM dynamics. Engle notes that a dominant partner may enjoy making a submissive partner inflate his testicles, while the submissive gains pleasure from the sensation and the experience of being dominated.
But not all motivation is sexual. ‘There’s a direct link with our perceptions of what makes you masculine,’ Engle says. ‘Having big balls and a big d**k is linked to being “more of a man”. The phrasing of having “big balls” suggests you’re braver, more assertive, and dominant, which is part of it, too.’
Research into the trend also points to deeper psychological drivers. For some, body modification can serve as a coping mechanism for anxiety, shame or depression, offering a sense of control and accomplishment. Others see it as a way to reclaim agency after trauma. The practice taps into the broader ‘looksmaxxing’ social media movement that encourages extreme measures to improve physical appearance, and into societal constructs of masculinity where ‘big balls’ are associated with bravery and dominance.
A step up from ‘scrotox’
Ballmaxxing should not be confused with ‘scrotox’ – Botox injections into the scrotum that have seen 46,000 online queries in the past four years as of 2025. Beverly Hills surgeon Jason Emer claimed he performed the procedure multiple times a week back in 2016. Scrotox aims to give men smoother skin, less ball sweat and a lower-hanging look. Ballmaxxing takes that concept to an extreme, using litres of saline rather than injectables to achieve dramatic, temporary enlargement.
Dr Shirin Lakhani, a sexual health specialist and aesthetics clinic founder, says there has long been male curiosity around scrotum enlargement. ‘It’s a consistent enquiry I get at my clinic,’ she says. ‘I’ve seen an increase particularly in men over 40, but I think procedures and plastic surgery have become more popular with men in general, and there’s less of a stigma now.’
The significant health risks explained
Medical professionals are unanimous in their warnings. The scrotum contains delicate structures – the testes, blood vessels and nerves – that are not designed to accommodate fluid distension. The risks range from discomfort to permanent injury and even death.
Infection and abscesses. ‘Introducing any unregulated fluid, especially outside of a medical practice, can cause infection, abscess formation or cellulitis,’ Dr Lakhani warns. Cellulitis is a bacterial infection of the skin and soft tissue that can spread rapidly.
Tissue and nerve damage. The extreme stretching involved causes microtears and bruising of the scrotal skin and underlying structures. This can damage connective tissues and nerves, potentially leading to long-term loss of sensation or structural changes that do not revert to normal, even after the fluid is absorbed.
Impaired blood flow to the testes. ‘Pressure from fluid accumulation may impair blood flow, potentially affecting testicular function,’ Dr Lakhani explains. Reduced blood flow can directly harm the testicles themselves. This can lead to erectile dysfunction, as the pressure disrupts the blood supply needed for an erection. In addition, compromised circulation can cause temporary or permanent infertility. In extreme cases, the death of testicular tissue (testicular loss) may occur.
Rupture of the scrotum. Over-inflation can cause the scrotal sac to tear or burst, requiring emergency surgical repair.
Life-threatening complications. Dr Lakhani warns of ‘even life-threatening possibilities such as blood clots or gangrene’. Gangrene occurs when body tissue dies due to lack of blood supply or infection; surgery is needed to remove all dead tissue to prevent the spread. Fournier’s gangrene – a rare but life-threatening bacterial infection of the perineum and genitals – is a specific risk. If air or gas is introduced (though less common with saline), an embolism can occur, where a bubble blocks a blood vessel.
Dr Joshua Zeichner, a dermatologist, has highlighted the risk of gangrene if blood flow is blocked. Dr Jonathan Redelinghuys, a medical doctor and psychologist, notes that repeated stretching can lead to permanent changes in the scrotum’s structure and function.
Pain and discomfort. Users on the Reddit forum frequently report a burning sensation, along with pain, swelling and inflammation. These are symptoms of inflammation or early infection.
Erectile dysfunction and infertility. As mentioned, impaired blood flow from inflation pressure can cause erectile dysfunction, while direct testicular damage can lead to infertility.
The overall consensus among medical experts is unequivocal: ballmaxxing should not be attempted at home. Gigi Engle warns that if anyone is considering it at all, the saline should be administered by a professional – though even then, the practice carries inherent risks.
Historical context and unregulated practice
Body modification has a long history across cultures, used for aesthetic enhancement, spiritual reasons, social status and life milestones. Genital augmentation specifically has included penile implants and, in the past, injections of silicone or paraffin – both of which led to severe complications such as abscesses and granulomas. Ballmaxxing follows in that tradition, but with the modern twist of online communities sharing techniques and tips. The practice is largely unregulated, with no medical oversight. Performing such procedures without medical training is illegal in the UK and can be considered assault or aggravated assault, even with consent, especially if significant harm results. However, a lack of regulation could push the practice further underground, increasing the risk of unqualified individuals performing injections.
Despite these dangers, interest continues. Sex expert Gigi Engle notes that in the kink world, ballmaxxing remains a relatively niche interest, but the online community’s growth suggests it is not going away. Medical literature has historically reported scrotal inflation only rarely, but the rise of social media platforms has given visibility to a practice that remains extremely hazardous.