Synthol injections

Synthol injections DEFAULT

If you're looking to get those biceps and triceps popping, here's exactly what not to do.

A 21-year-old Russian man is gaining attention for reportedly injecting his arms with synthol, a site enhancement that's 85% oil, 7.5% lidocaine, and 7.5% alcohol. Synthol injections are purely cosmetic; the substance doesn't offer any amount of strength gain, but simply causes the muscles to balloon. And it's seriously dangerous.

As you can see, Kirill Tereshin's arms look a little off—and studies indicate this could actually irreversibly damage the young man's muscles.

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A review of the usage of synthol in bodybuilding indicates that the substance is injected deep into muscles in order to provide an immediate and temporary enlargement of the muscle body. Some bodybuilders favor synthol injections over anabolic steroids, because synthol doesn't come with the long list of side effects associated with steroids. However, if case studies on synthol are any indication, the effects of synthol can be devastating and long-term, including permanent muscle disfigurement, muscle fibrosis, and the development of muscle ulcers and wounds. (Anabolic steroids also have a slew of long-term impacts.)

One case report looked at a 29-year-old bodybuilder who had injected synthol into his right bicep. Five years later, he presented to a doctor with pain and disfigurement over the bicep into which he'd injected the synthol. The doctors found that his bicep was not only still disfigured from the injection, but that he had developed muscle fibrosis, which is when the muscle develops scar tissue rather than muscle.

Related: Try the Metashred Extreme workout from Men's Health

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Another case report looked at a 45-year-old male bodybuilder, who developed ulcers in both of his arms a few years following synthol injections. The case report says the man's arms were "rock solid and clearly disformed." The right arm responded to antibiotic treatment, but the left arm ultimately needed surgery and "negative pressure wound therapy preparing the tissue for a split skin graft."

It's also important to point out that synthol injections are purely cosmetic—they don't offer any amount of strength gain. It's simply just causing the muscles to essentially balloon.

If these findings are any indication, Tereshin could be looking at some serious consequences years down the line if he continues this injecting.

Guys, don't inject your arms with oil. If you want to get those arms jacked, try this workout instead—it's actually designed to bulk up your biceps and triceps with real strength that won't land you in the hospital years down the line.

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Why Are Bodybuilders Using Synthol?

Bodybuilders often look for avenues to better their bodies beyond what they do at the gym. From supplements to high-protein diets to calorie-laden shakes, the bodybuilding industry remains a lucrative business for manufacturers. Bodybuilders will shell out major dollars for any advantage in this competitive field—and Synthol is one such substance.

What Is Synthol?

According to a review from the journal Polimery w Medycynie, Synthol is used by bodybuilders as a temporary implant that is injected deep into small muscle groups such as biceps, deltoids, and triceps. Why do they do this? Synthol offers immediate enlargement effects that can help them in competition.

In recent years, the pervasive nature of social media has helped spread Synthol use throughout the bodybuilding world and beyond. Such posts spread the word, causing other bodybuilders to start adopting it as part of their competition injections.

Although many think Synthol is a form of steroids, the liquid is actually an enhancement oil comprised of almost all oil.

Synthol is often marketed online as a "posing oil" to rub all over your body and give your muscles that preferred "shine" during competition. But that's not how bodybuilders typically use it. Rather, they inject the substance right into the body.


Consisting mostly of oil, the ingredient make-up of Synthol includes the following:

  • 85% oil built by medium-length triglyceride chains for the best effects (which is how Synthol can impersonate itself as a harmless topical product despite its potential hazards when injected into the body)
  • 7.5% alcohol to sterilize the mixture
  • 7.5% lidocaine, a local anesthetic used to reduce pain or discomfort

These ingredients have not been analyzed by the Federal Drug Administration (FDA). Such a lack of supervision poses major risks for use. The FDA even warns bodybuilders against using injections like Synthol for body contouring and enhancement.

Potential Side Effects

Despite its provocative, immediate effect on muscles, the substance is considerably dangerous to your health. Users will find visible drawbacks to using Synthol, such as the following:

  • A myocardial infarction can occur
  • Muscles can become deformed
  • Muscles can move into an unnatural shape, which doesn’t bode well for future competitions
  • Nerves can sustain damage
  • You can experience a pulmonary embolism
  • You can get an ulcer in the injected muscle
  • You could get an occlusion of the pulmonary artery
  • You increase your rate of a cerebral stroke, as the substance can travel to other parts of the body and block blood vessels in your brain, heart, and lungs
  • You might deal with infectious complications

Using Synthol for one competition can haunt you for years. The FDA says that such side effects could last for an undetermined amount after your injection. Often intensive and costly interventions are needed to treat the negative side effects, and you could keep needing these interventions for a long time after your initial injection.

FDA Guidance

For bodybuilders who still are considering using injections, the FDA asks you to please consider the following advice:

  • Discard any product that has strange labeling or looks different than usual.
  • Never get any form of injection for body enhancement. This means to never inject a filler between your muscles, as they can be dangerous and cause a serious injury and even death.
  • Never get any injectables from unlicensed providers.

Safer Methods to Build Your Body

There are many ways to get that "jacked," sculpted look bodybuilders desire. In short, you should spend your money on FDA-approved supplements, time in the gym, and consume a protein-heavy diet instead of dabbling in dangerous substances.

Follow a Bodybuilding Program

Rather than use a substance like Synthol to create an instant muscular effect, you should follow proper bodybuilding protocol and do it the safe way to keep your body healthy for years to come.

Look at high-frequency training for increasing lean mass and strength. In an April 2016 study from the International Journal of Exercise Science, researchers looked at a high-frequency training group versus a low-frequency training group. They found that working out three times per week, exercising with three sets per muscle group per session for three total-body workouts created the best results in comparison to a low-frequency training group, who performed a split routine.

After eight weeks of training, the high frequency training group increased lean mass by 1.9 percent and experienced strength improvements on the chest press by 11 percent and back squat by 21 percent.

Get Adequate Nutrition

A May 2014 study from the Journal of the International Society of Sports Nutrition says that most bodybuilders will respond best when consuming the following:

You should consume 2.3 to 3.1 grams of lean body mass per day of protein. You should also consume 15% to 30% percent of calories from fat. The remainder of the calories from carbs. In addition, follow these tips:

  • Consume a meal containing 0.4 to 0.5 grams per gram of bodyweight of protein prior to a weightlifting session
  • Don't try to dehydrate yourself for competition. It is dangerous and might not improve appearance
  • Eat three to six meals per day
  • For supplements: creatine monohydrates, caffeine, and beta-alanine have potential beneficial effects for contest preparation

Prioritize Mental Health

Because of bodybuilders' tendency to develop body image disorders, they should have access to a mental health professional.

Understand Multivitamins

According to the National Center for Complementary and Integrative Health, multivitamins and mineral supplements aren't needed for bodybuilders as long as they follow a healthy diet and consume enough calories for their long lifting sessions. The dietary supplements of zinc/magnesium aspartate, nitric oxidate precursors, chromium, and choline don't have any scientific evidence to prove they help bodybuilders gain strength and muscle mass.

Thanks for your feedback!

Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Pupka A, Sikora J, Mauricz J, Cios D, Płonek T. [The usage of synthol in the body building]. Polimery w Medycynie. 2009;39(1):63-5.

  2. U.S. Food & Drug Administration (FDA). The FDA Warns Against Injectable Silicone for Body Contouring and Enhancement. Published November 14, 2017.

  3. Sisti A, Huayllani MT, Restrepo DJ, et al. Oil injection for cosmetic enhancement of the upper extremities: a case report and review of literature. Acta Biomedica. 2020;91(3):e2020082. doi:10.23750/abm.v91i3.8533

  4. Thomas MH, Burns SP. Increasing Lean Mass and Strength: A Comparison of High Frequency Strength Training to Lower Frequency Strength Training. International Journal of Exercise Science. 2016;9(2):159-167.

  5. Helms ER, Aragon AA, Fitschen PJ. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. Journal of the International Society of Sports Nutrition. 2014;11(1):20. doi:10.1186/1550-2783-11-20

  6. National Center for Complementary and Integrative Health (NCCIH). Bodybuilding. Updated September 2017.

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Russian 'Popeye' has 3 pounds of 'dead' muscle removed after DIY bodybuilding injections

A 23-year-old bodybuilder in Russia, who has been nicknamed “Popeye” due to his abnormally large biceps, has recently undergone the first of at least three surgeries to remove roughly 3 pounds of “dead” muscle tissue after he injected a dangerous enhancement substance — Synthol — into his biceps and triceps.

Kirill Tereshin used “petroleum jelly” injections, or Synthol oil, to enhance the size of his arms, which, before surgery, were said to be 24-inchess around, the New York Post reported.

The 23-year-old has been nicknamed "Popeye" due to the size of his arms. (East2West)


Tereshin, who was reportedly told he could die or face amputation if he did not have the corrective procedure, was also encouraged to have the surgery by a Russian plastic surgery activist named Alana Mamaeva, according to the outlet. The 32-year-old reportedly helped to raise money for the surgery, which occurred at Sechenov Moscow State Medical University.

The man before the surgery. (East2West)

The surgery was performed by Dr. Dmitry Melnikov, who, according to the Post, estimated that Tereshin injected three liters — about 100 ounces — of the petroleum jelly-like enhancement substance into his arms. About 75 percent of what the doctor described as “scar tissue with fragments of muscles” was removed during the first of possibly three surgeries.


Kirill Tereshin during the first of possibly three surgeries to remove the implants. (East2West)

“It saturated the muscle tissues, blocked blood flow,”  Melnikov said, according to the Post. “As a result, the tissue dies and gets replaced with a scar which is as tough as a tree.”

He added: “We have seen petroleum jelly injected into breasts, buttocks and other parts of the female body,” he said. “We are warning that it is extremely dangerous.”

Dr. Dmitry Melnikov holds a lump removed from Tereshin's left tricep. (East2West)

Synthol oil is purely cosmetic, causing the muscles to “balloon” and appear bigger than they really are. The substance is injected deeply into the muscle and typically consists of oil, benzyl alcohol, and lidocaine, according to a 2009 review on the usage of Synthol in bodybuilding. 


Kirill Tereshin in the days before the surgery. (East2West)

The substance, which is most often used in the triceps, biceps, deltoids and calf muscles, has “some serious drawbacks,” per the review. Most obviously, the substance can cause muscles to become abnormally shaped, but “The side effects of Synthol are manifold and they can also cause damage of nerves, oil embolic of the pulmonary, occlusion of the pulmonary artery, myocardial infarction, cerebral stroke, and infectious complications,” according to the review.

Melnikov said his patient was “lucky” that the injections did not affect any other parts of his body.

Madeline Farber is a Reporter for Fox News. You can follow her on Twitter @MaddieFarberUDK.

What You Should Know About Synthol Injections

Painful muscle fibrosis following synthol injections in a bodybuilder: a case report

Suleiman Ghandourah

1Department of Orthopaedics, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

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Markus J Hofer

2Department of Neuropathology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

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Andreas Kießling

3Department of Radiology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

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Bilal El-Zayat

1Department of Orthopaedics, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

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Markus Dietmar Schofer

1Department of Orthopaedics, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

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Author informationArticle notesCopyright and License informationDisclaimer

1Department of Orthopaedics, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

2Department of Neuropathology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

3Department of Radiology, University Hospital Marburg, Baldingerstrasse, Marburg 35033, Germany

corresponding authorCorresponding author.

Suleiman Ghandourah: [email protected]; Markus J Hofer: [email protected]; Andreas Kießling: [email protected]; Bilal El-Zayat: [email protected]; Markus Dietmar Schofer: [email protected]

Received 2011 Dec 13; Accepted 2012 May 22.

Copyright ©2012 Ghandourah et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC.



Synthol is a site enhancement oil used by bodybuilders to boost the cosmetic appearance of muscles. Here, we describe the case of a patient with severe side effects following repeated intramuscular injections of synthol in his right biceps muscle.

Case presentation

A 29-year-old Middle Eastern male bodybuilder, following intramuscular injections of synthol five years ago, presented with painful pressure in his right upper arm. On presentation to our clinic, his muscle appeared disfigured. Magnetic resonance imaging revealed scattered cystic fatty lesions in the muscle. The affected part was surgically removed and histopathology showed inflammatory changes with fibrosis and a so-called Swiss cheese pattern.


Synthol injections that are used for the short-term enhancement of muscle appearance by bodybuilders bear the danger of long-term painful muscle fibrosis and disfigurement.


Site enhancement oils were first introduced in 1899 for the purposes of breast augmentation and the filling of wrinkles [1,2]. Synthol, one of the substances used for this purpose, is composed of 85% oil (medium-chain triglycerides), 7.5% lidocaine and 7.5% alcohol. Following injection with synthol, the injected muscle undergoes immediate enlargement. However, this method can also result in muscle deformity [3].

Case presentation

A 29-year-old Middle Eastern male bodybuilder with a history of prior repeated synthol injections presented at our clinic with ongoing pain and deformity in both upper arms. At the age of 25, our patient had 3mL synthol repeatedly injected by an unlicensed friend into both biceps brachii muscles. Injections were administered four times per week for a total period of four weeks. The total number of injections was 16 injections per biceps muscle. Our patient experienced pain and pressure in the injected muscle directly after each injection. The pain was rated initially as four using a visual analogue scale retrospectively. Despite this, a training session was carried out by our patient after each injection. His perception of pain gradually increased to six out of ten, and after two years our patient ceased training due to the severe pain (rated seven out of ten). Initially, our patient had been able to withstand the pain but, after two years of drug administration, the pain was increasing and not tolerable due to its constant and persistent nature.

Upon physical examination, our patient was observed to have rubbery firm hypertrophic and dysmorphic biceps in both arms (Figure ​1) with a free range of motion. He complained of a constant painful pressure within his right muscle more than his left one, and muscle deformity. He had several tender points all over his biceps muscle. A diagnosis was made through magnetic resonance imaging (MRI), which revealed a swollen right biceps muscle and cystic lesions scattered throughout the muscle tissue with a hyperintense signal. MRI indicated these lesions to be oil deposits between muscle fibers, termed oleomas (Figure ​2). It was concluded that his muscle underwent fibrotic changes in its appearance. In addition, contrast enhancement was inhomogeneous, indicating the presence of inflammation (Figure ​3).

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Figure 2

Magnetic resonance image of swollen biceps muscle after intramuscular injection of synthol in (A) coronal T1-weighted turbo spin echo sequence and (B) transverse T2-weighted turbo spin echo sequence. Due to the presence of fat in the injected suspension, the total muscle had a hyperintense signal in T1-weighted and T2-weighted images compared with the surrounding healthy muscles. Several cystic lesions are scattered within the muscle with a hyperintense signal. These lesions are oil deposits between the muscle bundles.

For ongoing pain and with no therapeutic alternatives, an open surgical excision of the anterior third of his biceps was carried out through an anterior bicipital approach. Intraoperative findings showed no common muscle tissue left but massive fibrotic tissue similar to scar tissue. Postoperatively, our patient experienced a release of the subjective pain and intracompartmental pressure.

The operative specimen, measuring 11.0cm × 5.0cm × 5.0cm, was sent to the Department of Neuropathology for histological examination. The diagnosis was reconfirmed as fibrosis. Sections of the unfixed material revealed a white to yellowish lesion with intermingled small fragments of muscle. Histology showed a predominance of connective tissue with vacuoles (Figure ​4A,B,C) and small areas of striated muscle with myopathic changes (Figure ​4A,B,C; asterisks). Several necrotic muscle fibers were observed. The connective tissue contained inflammatory infiltrates that were in part diffusely distributed, in part accumulated in foci (Figure ​4A,B; arrows). The infiltrates were dominated by CD68+ macrophages (Figure ​4D) with numerous multinucleated giant cells (Figure ​4D; arrows) and lymphocytes (Figure ​4D; arrowhead). Immunohistochemistry identified the lymphocytes as CD4+ and CD8+ T-cells as well as CD20+ B-cells (not shown).

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Figure 4

The overview shows the destroyed muscular architecture and replacement of the muscle by connective tissue. ( A) Residual muscle fibers (asterisks) show pronounced myopathic changes while the connective tissue contains vacuoles with inflammatory infiltrates (arrows). Hematoxylin and eosin stain , ×10 magnification. ( B) Higher magnification reveals inflammatory infiltrates in the connective tissue and surrounding the vacuoles. Hematoxylin and eosin stain, ×40 magnification. ( C) Elastica van Gieson stain shows remaining muscle fibers (asterisks) with intermingled connective tissue and vacuoles, ×20 magnification. ( D) Multinucleated giant cells (arrows) and mononuclear infiltrates (arrowhead, cells negative for CD68) surround vacuoles, ×40 magnification.

Two weeks postoperatively, our patient was satisfied with the outcome. He was advised to withhold vigorous training for a period of 12 weeks. No complications were reported. After six months, the patient requested the same procedure to be done on his left biceps and surgery was carried out later.


There are not many case reports in the literature that document complications from the use of synthol in bodybuilders. However, there are several reports of complications in patients after injections of paraffin, sesame- and walnut oil [1,4-7]. They all share common histological findings with an inflammatory foreign body reaction, fibrosis and extensive vacuolation [6]. The latter is also known for producing a ‘Swiss cheese’ appearance [5,6], while individual cysts are named according to the injected material, for example, oleoma or paraffinoma [6,7].

Such enhancement oils do not increase muscular strength or performance and are used solely for cosmetic purposes [1]. In the presented case, our patient was under social pressure to use synthol to improve his appearance. However, two years after the injections, the increasing fibrosis and concomitant disfigurement of the muscular appearance caused embarrassment due to his negative body image. Other potential side effects that have been reported include oil embolism, myocardial infarction, cerebral stroke, ulcers and infections [3,6].


Although the use of synthol by bodybuilders supplies them with the desired short-term effects, the compound progressively destroys the injected muscle. Users are frequently drawn to synthol as it does not share the side effects of androgenic anabolic steroid hormones. However, our case study demonstrates that, despite these perceived advantages, synthol can also have severe and potential life-threatening consequences for its users.


Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SG and MDS analyzed and interpreted the patient data regarding synthol intramuscular injections. MDS carried out the surgical intervention on the patient. SG, BEZ and MDS were the main writers of the manuscript. MJH performed the histological examinations of the biceps muscle, AK carried out the radiological examination, and both were major contributors in writing the manuscript. All authors read and approved the final manuscript.


We thank Prof. Axel Pagenstecher for his help with the histological examination of the operative specimen and Claire L. Thompson for critically reading the manuscript.


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