Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lacking. This is known as "fluffing". Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol. It is not restricted, and many brands are available on the Internet. The use of injected oil to enhance muscle appearance is common among bodybuilders, despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma, stroke, and the formation of oil-filled granulomas, cysts or ulcers in the muscle. Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life.
On January 16, 1904, the first large-scale bodybuilding competition in America took place at Madison Square Garden in New York City. The competition was promoted by Bernarr Macfadden, the father of physical culture and publisher of original bodybuilding magazines such as Health & Strength. The winner was Al Treloar, who was declared "The Most Perfectly Developed Man in the World". Treloar won a $1,000 cash prize, a substantial sum at that time. Two weeks later, Thomas Edison made a film of Treloar's posing routine. Edison had also made two films of Sandow a few years before. Those were the first three motion pictures featuring a bodybuilder. In the early 20th century, Macfadden and Charles Atlas continued to promote bodybuilding across the world. Alois P. Swoboda was an early pioneer in America.
The important role of nutrition in building muscle and losing fat means bodybuilders may consume a wide variety of dietary supplements. Various products are used in an attempt to augment muscle size, increase the rate of fat loss, improve joint health, increase natural testosterone production, enhance training performance and prevent potential nutrient deficiencies.
The winner of the annual IFBB Mr. Olympia contest is generally recognized as the world's top male professional bodybuilder. Since 1950, the NABBA Universe Championships have been considered the top amateur bodybuilding contests, with notable winners such as Reg Park, Lee Priest, Steve Reeves, and Arnold Schwarzenegger. Winners generally go on to become professional athletes.