SmoothSac™ uses neurotoxin products that are FDA-approved for other indications and used off-label for scrotal application. It is performed by licensed physicians trained in the technique, and the injection targets the dartos muscle layer. Known risks include bruising, swelling and tenderness, bleeding under the skin (hematoma), infection, uneven results, and a scrotum that hangs lower than you wanted until the toxin wears off. Injecting near the testicles also carries a risk of injury to them. All botulinum toxin products carry an FDA boxed warning that the toxin's effect can spread beyond the injection site and cause trouble swallowing or breathing, which can be life threatening. Discuss these risks with your physician before treatment.

Will Scrotox affect my fertility or sperm count?

Botulinum toxin is injected into the muscle layer above the testes — not into the testes directly. While animal studies at very high doses have shown potential effects on spermatogenesis, clinical experience in humans at standard doses has not demonstrated significant fertility concerns. However, if you are actively trying to conceive, discuss this with your physician during consultation.

How long do SmoothSac™ results last?

Results typically last 3–4 months. Some patients report effects lasting up to 6 months. Repeat treatments are available, and some patients find that results last progressively longer with repeated sessions as the muscle weakens over time.

Scrotox · Scrotal Botox

Scrotox — Scrotal Botox for a Smoother, More Relaxed Scrotum

Q: How much does scrotal Botox cost?

SmoothSac™ is priced at $890-$1890 per treatment (depending on quantity.). Financing is available through CareCredit, Cherry, and United Credit. Visit our pricing page or financing page for details.

A targeted neurotoxin treatment that relaxes the scrotal dartos muscle, reducing wrinkling and tightness for a smoother, more natural appearance. Quick in-office procedure, no downtime.

Free Phone Consultation Upsize™ Procedure

Medically reviewed by Dr. Joel Pash · Updated July 2026

About the Treatment

What Is Scrotox? How Scrotal Botox Improves Appearance

SmoothSac™ is a scrotal neurotoxin treatment — commonly known as "Scrotox" or "scrotal Botox" — that reduces scrotal wrinkling and tightness for a smoother, more relaxed appearance. By injecting botulinum toxin (Botox, Xeomin, or Dysport) into the dartos muscle — the smooth muscle layer beneath the scrotal skin — SmoothSac™ temporarily prevents the contraction reflex that causes the scrotum to tighten and wrinkle.

The result is a smoother scrotal surface, a more relaxed hang, and a visually fuller appearance — benefits that many men report significantly improve their appearance and comfort. SmoothSac™ also helps reduce excessive scrotal sweating (hyperhidrosis) by inhibiting sweat gland activity in the treated area. The quick 15–20 minute in-office procedure requires no general anesthesia and no downtime. SmoothSac™ is available at all 29 Upsize™ clinic locations and can be performed alongside the Upsize™ filler procedure or Firm-X™ treatment.

At a Glance

SmoothSac™ Scrotal Botox Quick Facts

15–20Minute Procedure

3–4 moResults Duration

50–100 unitsDosing

$1,890Per Treatment

Why SmoothSac?

Benefits of Scrotal Neurotoxin Treatment

Smoother Appearance

Reduces excessive scrotal wrinkling by relaxing the dartos muscle, creating a cleaner, more aesthetically pleasing surface.

More Relaxed Hang

Prevents the retraction reflex that pulls the scrotum tight against the body, allowing a naturally lower, more relaxed position.

Reduced Sweating

Inhibits sweat gland activity in the scrotal area, reducing excessive scrotal sweating (hyperhidrosis) for improved comfort and hygiene.

Fuller Visual Appearance

A relaxed scrotum appears visually larger and fuller — enhancing overall genital aesthetics.

Pairs with Upsize™ & Firm-X™

Combine with the Upsize™ filler procedure and/or Firm-X™ neuromodulator for comprehensive genital enhancement in a single visit.

Quick & No Downtime

15–20 minute in-office treatment. No general anesthesia. Return to normal activities immediately — there is no recovery period.

The Process

How Scrotal Botox Treatment Works

Consultation

A confidential evaluation with your physician to discuss goals, expectations, and whether SmoothSac™ is right for your situation.

Preparation

The scrotal area is cleansed and your physician marks the optimal injection sites.

Scrotal Botox Injection

Botulinum toxin is injected into the dartos muscle at multiple points using a fine needle. Your physician sets the dose. The process takes about 15–20 minutes.

Enjoy Results

Effects develop over 1–2 weeks. A smoother, more relaxed scrotum with reduced wrinkling, less sweating, and a fuller visual appearance. No recovery period.

Is It Right for You?

Who Is a Good Candidate for Scrotox?

Botulinum toxin products carry an FDA warning about effects spreading beyond the injection site. See the safety note.

Risks to know about

Bruising, swelling and tenderness of the scrotum after the injections. This is the most common effect and settles on its own.
Hematoma (bleeding under the skin). The scrotum has a rich blood supply, so a collection of blood can form. It can be painful and can take weeks to clear.
Infection at an injection site.
Too much relaxation. The muscle that lifts and lowers the scrotum is what is being relaxed. Some men find the scrotum hangs lower than they wanted, or that it no longer lifts in the cold. This lasts until the toxin wears off.
Effects on the testicles. Injecting near the testicles carries a risk of injury to them or to the cord above them. Tell your doctor straight away about any testicle pain, swelling or lump.
Uneven results, where one side responds more than the other.

This is a cosmetic treatment and this use of botulinum toxin is off-label — it is not FDA-approved for the scrotum. Your physician goes through these risks with you before treatment.

✓ Good Candidates

Men bothered by excessive scrotal wrinkling or tightness

Men who experience scrotal retraction ("shrinkage") in cold or stressful conditions

Men with excessive scrotal sweating (hyperhidrosis)

Men seeking a fuller, more relaxed scrotal appearance

Men combining with Upsize™ or Firm-X™ for comprehensive enhancement

✗ May Not Be Candidates

Men with neuromuscular disorders (e.g., myasthenia gravis)

Men with active infection in the scrotal area

Men with known allergy to botulinum toxin products

Men on blood thinners (discuss with physician first)

Not sure if you're a candidate? Schedule a free phone consultation — an Upsize™ expert will go through your situation, and your physician confirms candidacy at your visit.

Questions?

Scrotal Botox & Scrotox FAQ

Scrotox — also called scrotal Botox or scrotal neurotoxin therapy — is a cosmetic procedure where botulinum toxin (Botox, Xeomin, or Dysport) is injected into the scrotal skin. It relaxes the dartos and cremaster muscles, reducing wrinkling and allowing the scrotum to hang in a smoother, more relaxed position.

Botulinum toxin blocks the release of acetylcholine at the neuromuscular junction, temporarily preventing muscle contraction. When injected into the scrotal dartos muscle, it reduces the retraction reflex that causes tightening and wrinkling — resulting in a smoother appearance and more relaxed hang.

Most patients report minimal discomfort. The injections themselves are quick — the entire treatment takes only 15–20 minutes. Most patients describe the sensation as a brief pinch.

SmoothSac™ uses neurotoxin products that are FDA-approved for other indications and used off-label for scrotal application. The procedure is performed by licensed physicians with procedural training in this technique. As with any injection, side effects can occur and may include swelling or bruising. Risks specific to your situation should be discussed with your physician during consultation. The injection targets the dartos muscle layer.

The toxin goes into the muscle layer above the testes, not into the testes, and we are not aware of any fertility problems reported in men after scrotal treatment. It has not been formally studied in humans, and animal studies at high doses did affect sperm production — so if you are trying to conceive, raise it with your physician at the consultation.

Yes. Many patients add SmoothSac™ as a complement to their Upsize™ filler procedure or Firm-X™ neuromodulator treatment for comprehensive genital aesthetic enhancement in a single visit. Your physician will advise on the optimal approach.

Effects typically develop over 1–2 weeks as the neurotoxin takes full effect. You may notice initial relaxation within the first few days, with full smoothing and hang visible by week 2.

Results typically last 3–4 months. Some patients report effects lasting up to 6 months. Repeat treatments are available. With repeated treatments some men find the effect lasts longer, as the muscle gradually does less work.

SmoothSac™ is priced at $1,890 per treatment. Financing is available through CareCredit, Cherry, and United Credit. Visit our pricing page or financing page for details.

SmoothSac™ is available at all 29 Upsize™ clinics nationwide. Visit our clinic finder to locate your nearest office, or call for a free phone consultation.

Pricing

How Much Does Scrotox Cost?

$1,890

Per SmoothSac™ treatment · Financing available

CareCredit Cherry United Credit

Combine with Upsize™ and/or Firm-X™ for comprehensive enhancement — ask about package pricing.

Explore Financing Options

Take the Next Step

Book Your SmoothSac™ Consultation

Speak confidentially with an Upsize™ expert about scrotal Botox and whether SmoothSac™ is right for you. Free phone consultation, no obligation.

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FDA Boxed Warning: Distant Spread of Toxin Effect

Every botulinum toxin product carries this warning from the FDA. The effect of the toxin can spread away from where it was injected. When that happens it can cause muscle weakness, blurred vision, drooping eyelids, trouble swallowing, trouble speaking, and trouble breathing. Swallowing and breathing problems can be life threatening, and deaths have been reported. Symptoms have shown up anywhere from hours to weeks after an injection. Get emergency help straight away if you have any trouble swallowing, speaking or breathing after treatment.

Tell your doctor before treatment if you have a nerve or muscle disorder such as myasthenia gravis, Lambert-Eaton syndrome or ALS, if you have had any swallowing or breathing problem, or if you have had any botulinum toxin injection in the last four months.