The article reports on four cases of penile modifications, known in medico-social literature as artificial penile nodules, observed during the external coronial autopsy examinations of three males of Southeast Asian origin, admitted over a five-week period, and a Australian youth admitted 30 months previously as a death in custody. Fang muk, bulletus, chagan balls, tancho balls, and penis marbles are terms synonymous with the ethno-sexual practices of various sub-cultural groups of South-east Asian males, the terminology being specific to the geographic region. It describes the implanting of firm spherical foreign objects, in the form of beads, in the subcutaneous tissue of the shaft of the penis proximal to the glans to allegedly enhance the sexual pleasure of females during sexual intercourse. Non-Asian nationalities such as Romanians (Wolf and Kerl, 1991), Russians (Serour, 1993) Fijians (Scott and Norton, 1993) and Middle Eastern males have also adopted this practice within sub-cultural groups of society. The article provides a brief historical account and the social, motivational, and occupational characteristics of individuals adopting this sexual practice and the surgical and health side effects of the implantation of artificial penile nodules, relating these aspects to the forensic cases observed.