- Ballmaxxing is the latest social media “maxxing” trend.
- The protocol involves injecting fluids into the testicles in order to increase their size.
- Experts caution that this trend may do more damage to the body than good.
The latest maxxing trend is known as “ballmaxxing,” in which men inject fluids like Surgilube or saline into their testicles to increase their size.
Saline is a sterile solution of sodium chloride in water used for medical and health purposes. Surgilube is a sterile, water-soluble surgical lubricant used clinically to facilitate the insertion of medical instruments, catheters, and endoscopes. It’s designed for external medical use and instrument lubrication.
Some participants in this trend are injecting these fluids until their testicles are the size of grapefruits.
The question on everyone’s mind with this new trend is, “Why?”
Some say that increasing their scrotum size makes them feel more masculine and confident. Others say that they believe women prefer larger testicles. While others state that it can enhance sex and the pleasure that comes from sex. Another reason may simply be fascination.
Whatever the reason, experts warn that this trend may actually cause more harm than people may realize.
“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,” Robert Glatter, MD, attending physician in the Department of Emergency Medicine at Lenox Hill Hospital in New York City, and Assistant Professor of Emergency Medicine at Zucker School of Medicine at Hofstra/ Northwell, said.
Glatter spoke to Healthline about this potentially dangerous trend.
This interview has been lightly edited for length and clarity.
Glatter: The short answer: The scrotum was not built for this. 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.
Specific risks include infection, abscess formation, and cellulitis from the introduction of unregulated fluid outside a medical setting. Pressure from fluid accumulation may also impair blood flow, potentially affecting testicular function — in other words, the very organs someone is trying to “enhance” can be permanently damaged in the process.
Most ballmaxxing happens at home with kits bought online, with no sterile field and no trained operator, making sepsis a potential and serious outcome.
Others may purchase materials from underground sources, which may contain toxic materials that are not only harmful but also unsterile, increasing the risk of severe infection, sepsis, and the need for surgical intervention with potential permanent disfigurement.
Glatter: Even medical-grade saline, when injected outside a clinical setting by an untrained individual, carries serious risks.
Without proper sterile technique, you are essentially introducing bacteria directly into a warm, enclosed anatomical space — ideal conditions for a rapidly spreading infection, death of tissue, requiring surgical debridement and potentially scrotal removal or resection in the setting of impending necrotizing fasciitis, a potentially fatal condition if not recognized and treated immediately with surgical intervention and aggressive IV antibiotics.
Surgilube compounds this further: it is not bioabsorbable, meaning the body cannot break it down and eliminate it, unlike saline, which it can eventually reabsorb. The result can be persistent foreign body reactions, disfigurement, and the need for surgical intervention to remove embedded material.
Simply put, it is not intended for injection into body tissue. Injecting a viscous lubricant into scrotal tissue introduces a foreign substance that the body has no mechanism to absorb or clear, raising the risk of granuloma formation (localized area of inflammation), chronic inflammation, and necrosis (tissue destruction) on top of all the infection risks saline alone already poses.
Glatter: [Safer strategies] involve going to see a board certified urologist for evaluation.
Testosterone replacement therapy (TRT), when medically indicated, can help preserve testicular volume, though it paradoxically suppresses natural testosterone production and can reduce testicular size in some cases — a nuance worth discussing with an endocrinologist and urologist.
For males concerned about aesthetic appearance after significant volume loss (for example, following orchiectomy or surgical removal of a testicle), prosthetic testicular implants are a legitimate surgical option performed by trained urologists in sterile operating environments.
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