When it is a hot day outside, and your balls ride on each other and the inside of your thighs. The result is a chafed up ball sack. The Buffalo Bill Ballsack isn't fully complete however, until you get an erection and put a little cowboy hat on the tip of your penis.
Joe: Holy cow, it's like 100 degrees out here!
Fred: Yea i'm getting a major Buffalo Bill Ballsack.
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