Men are inflating their scrotums, doctors warn of serious risks

It’s enough to make any man cross his legs, but a niche and somewhat extreme form of body modification is surfacing in online spaces and, according to medical professionals, in some South African doctors’ rooms.

Men are using various substances to inflate their scrotums, sometimes to a size doctors equate to two large cantaloupes.

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This comes hot on the heels of the ski jumper penis-doping scandal, where some ski jumpers were injecting hyaluronic acid into their members. According to reports, the guilty sportsmen said that it was done to increase size, creating a larger or more aerodynamic surface area and allowing for better flight distance when they jump.

However, scrotum inflation is done for different reasons altogether.

Medical doctor and psychologist Dr Jonathan Redelinghuys said the behaviour appears to be linked to a small and largely non-mainstream subculture.

“There appears to be a kind of a sexual subculture of people,” he said, explaining that individuals are injecting substances into the scrotum, not the testicles themselves, to alter its size and appearance.

“It appears that they derive some kind of sexual pleasure from them or an audience who derives pleasure from it,” he said, adding that the exact mechanism behind that response is not clearly understood.

Silicone or saline injected

It’s a practice that, while rare, carries significant risk. Usually, it involves injecting substances such as saline and silicone into the scrotum to increase its size, often dramatically, in ways that fall well outside regulated medical procedures.

According to MenRUS, saline injections involve “injecting sterile 0.9% salt water solution into the scrotum to make it temporarily larger,” with the scrotum expanding “like a water balloon” and, in some cases, reaching the size of a grapefruit before the body gradually absorbs the fluid again.

The effect is temporary, typically lasting a day or two, the site noted, but the visual impact is immediate and that seems to be the objective.

Supersized scrotums can match a cantaloupe. Picture iStock

The medical risks, however, are not temporary.

“Both saline and medical-grade silicone can come with complications,” Dr Redelinghuys said. “The person is at risk for developing an infection, injection site reaction, body reactions, even if it was completely sterile, it would still not be 100% safe.”

The procedures are often performed outside of clinical environments, which increases the likelihood of contamination, incorrect technique and delayed treatment when complications arise.

Medical risks are not temporary

Saline is sometimes viewed as a lower-risk option because it is absorbed by the body over time, but Dr Redelinghuys cautioned that this does not make the practice safe. Repeated injections can change the structure of the tissue itself.

“With repeated injection, it becomes more compliant,” he said. “People aim for larger and larger kinds of volume; it could potentially go up to litres at a time.” It could reach the size of “a large melon or an inflated balloon”.

A level of such large expansion has practical and medical consequences. As the tissue stretches, it does not necessarily return to its original state once the fluid is absorbed.

“The skin doesn’t just go back to what it once was,” Dr Redelinghuys said. “Over time, this can lead to permanent changes in the structure and function of the scrotum.”

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Silicone, medical grade or not, can cause real problems. Unlike saline, it does not absorb into the body and remains in the tissue, often leading to chronic inflammation, hardening or migration.

“Silicone would most likely need to be surgically removed, or suctioned,” Dr Redelinghuys said.

By that stage, intervention is no longer cosmetic but corrective, and outcomes can be unpredictable.

A bit of fun can have serious consequences

Another medical professional said to consider earlobe modifications and what ears look like when inserted discs or objects are removed.

“Once the skin is stretched and damaged, it will just dangle,” they said. “The same counts for the scrotum, it’s an inevitable consequence.”

The wages of body modification and scrotal inflation could be permanent. Picture iStock

Dr Redelinghuys said that while still the exception rather than the rule, digital culture and the spread of ideas via social media is slowly pushing the popularity of some practices northward.

“As people are able to share their interests with one another on online platforms and generate interest or join groups where common interests are shared, people are becoming a little bit more aware of it,” he said.

Scrotum inflation also does not exist in isolation from broader trends in body modification. Procedures aimed at altering appearance, from implants to injectables, have become more widely accepted over time.

“Body modification for decades, if not centuries have been part of the human condition. People derive satisfaction, interest and pleasure from their appearance,” Dr Redelinghuys said.

The difference in this case lies in the extremity of the method and the vulnerability of the area involved, particularly when carried out without medical supervision. However, he warned, “the body does not adapt without consequence to any modification.”

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