John Perez first heard about Botox for your ball sack—colloquially referred to as Scrotox—from some friends who had had it done, and liked the results. "It’s popular in Europe," Perez said, rather casually, admitting that he first encountered it over dinner at a friend's house, around six months before he decided to have the procedure himself, in late-November. "I was interested in it because my friends were excited about it, talking about it."
Testicular Botox has many purported benefits, like as a treatment of excessive sweating, the same way the neurotoxin is used in underarms and on palms. But its growing popularity is due to men who are employing it for aesthetic reasons, specifically to smooth out wrinkles on their testes and make them look bigger. And then there's this: "The most interesting part to me is that it would improve my sex life," says Perez, a 35-year-old working in the fashion industry. "That it would make everything more sensitive."
"People are definitely asking about it, talking about it" says Dr. Evan Rieder, a board-certified cosmetic dermatologist and psychiatrist at NYU Langone Medical Center. In fact, Dr. Rieder first reached out to me, saying he had seen a noticeable uptick in men inquiring about the procedure. "Dave Chappelle was talking about smoothing out the scrotum ten years ago," he says. "It's not a novel concept, but it's new in that people are actually doing it." Dr. Rieder has been approached by men over the last six months or so, and while it still may be rare, he says that colleagues in urology seem to be encountering clients interested in the procedure with more frequency. One of those urologists is Dr. Seth Cohen, a colleague at NYU Langone Medical Center, confirms the sudden interest and traces it back to a British newspaper article, extolling the procedure's benefits to men. While the numbers of men talking about it and having it done, remain small, it's a jump from the previous number: zero.
As plastic surgery becomes normalized (there was a reported 337% increase in male procedures between 2000 and 2015) many consider going under the knife more like grooming upkeep rather than some taboo treatment. This has led to more niche, specific forms of these cosmetic procedures surfacing as options. "Especially over the past couple of years, men have become more comfortable asking—not only dermatologists but plastic surgeons and urologists—about the appearance of their bodies, including the penis and scrotum."
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The procedure is relatively simple: Doctor's apply a topical cream to numb the area and inject the testicle skin (no needles go into the actual sack). This is done multiple times in the selected area, with Botox from a fine needle, as it would be done to a creased forehead or a smattering of crows feet around the eye. The downtime is virtually non-existent, and Dr. Rieder says that it will set you back around $1,000, the going rate for 50 units of Botox, which is a small amount, compared to what someone would get in the face, but at this early point in the procedure's history, it's best to start with a conservative amount. Typically, this should provide a patient with three to four months of bulging balls.
Perez made it clear that it was a completely pain-free procedure, and that he was happy with the results, going as far to say that he would like to have it done again, when the effects of this round eventually wear off. "My doctor was a little more conservative in what he gave me," he said. "Next time I'd ask him to be a little more aggressive because I liked the results." It took him a week or so to see any difference, but admitted that, yes, he looked bigger, and said if there was anything he'd warn people about, it's that for a few days after the surgery, his ball sack felt heavier than usual, but nothing too bad.
And while Perez did feel increased sensitivity, he was surprised at how much he enjoyed the new, smoother appearance of his, uh, sack. The verdict is still out with regard to sweating, as Perez had his procedure during the colder months. Still he's willing to find out next go around.
There are some things to consider, however. "I do tell my patients that it could potentially affect their sperm count," says Dr. Cohen, the urologist, noting that your scrotum contracts and expands to help regulate temperature for optimal health for your little guys. While these are temporary results, if you're actively seeking to have children, Cohen suggests staying away from the needle. For more active men, Dr. Cohen suggests being more aware of their testicles during sports and other vigorous movement.
How big could the ball Botox movement go? Well, it's incredibly specific, but that doesn't mean it could never gain traction. "This is an off-label usage for Botox, so for it to gain traction it would have to be done by a lot more people," Dr. Cohen noted, skeptically about the possibility for this to avalanche into anything bigger. Still, the procedure is new, and even all your friends did have it done, how would you know?