In our current era of everywhere, all the time Botox, there’s a good chance you’ve at least thought about getting a few units here or there. Maybe you’d like to smooth out some forehead wrinkles or put an end to a certain sweaty palms situation (yes, Botox can do that). One place you probably haven’t thought about Botoxing? Your butt—the hole part, to be specific.
Yes, anal Botox is a thing—and, thanks to a certain butthole Botox moment in the new Netflix series, Uncoupled, it’s a thing a lot more people just became aware of. In case you happened to miss anal Botox’s big TV debut, here’s a quick rundown. Neil Patrick Harris’s newly single character is stressing out about hooking up with a hot dermatologist, who happens to be packing some particularly sizable hardware, when the dreamy derm whips out an “off-label” anal paralytic he apparently keeps in his bedside drawer. According to Dr. McDermy, a few cc’s of butt-tox is a handy “workaround” for any physical limitations that may prevent you from, well, getting it in.
While the idea of having his butthole Botoxed by a handsome hookup was enough to send NPH’s character running for the hills, it turns out a little Botox in the butt is actually NBD—provided it’s administered by a licensed professional in a designated medical setting and not by a Tinder rando in his bedroom, that is.
“Most people assume Botox can only be applied to the face (for wrinkles) or underarms, (to curb sweating) but there are also successful applications and treatments for the anus,” says anal surgeon Evan Goldstein, DO, founder of Bespoke Surgical and Future Method. “It’s a complete game changer—not only for comfortable and enjoyable anal sex, but also for better post-operative management after anal surgical procedures.”
Moreover, while Uncoupled may have been many people’s first intro to the world of butt Botox, it’s actually a pretty common practice. Dr. Goldstein says he uses anal Botox with his patients on a daily basis.
That said, there are a few things—by which we mean a lot of things—Uncoupled got wrong about Botoxing your butthole. To help set the record straight, we asked Dr. Goldstein to give us the lowdown on all things anal Botox. Consider your burning butt-tox questions answered.
What actually is anal Botox?
Basically, anal Botox is what it sounds like: Botox up the butt. But, uh, why? We can explain. (Hint: It’s not about maintaining your asshole’s youthful appearance.) But first, a little anatomy lesson.
“The ass has muscle and skin. The key for anal sex is to get both to open up,” says Dr. Goldstein. “The muscle must fully relax and the skin must fully accommodate. When you achieve both of these simultaneously, the sky’s the limit.”
However, some people have what Dr. Goldstein calls “restrictive components,” AKA, they’re too tight. As the anal expert himself puts it: “I view the ass as a rubber band, and some bands are simply too tight.” Combine these physical limitations with the mental anxieties many of us already have about anal, and things can get pretty uncomfortable. That’s where anal Botox comes in.
“Anal Botox allows relaxation of the internal anal sphincter muscles as well as the overlying skin it’s applied to in order to achieve a desired goal,” says Dr. Goldstein. That goal might be related to post-operative anal surgery, orrr it might be about taking a big ol’ honking dick up your ass. (Both are completely valid, BTW.) Basically, the relaxation properties of anal Botox can help “set the stage for successful anal engagements,” as Dr. Goldstein puts it.
What Uncoupled got wrong about Botoxing your butthole
For starters, you should not be getting Botox of any kind in anyone’s bedroom. Also, it doesn’t actually work like that anyway.
“It’s definitely not just a bend-over-and-Botox-your-hole kind of situation,” says Dr. Goldstein. While the hot derm from Uncoupled made it seem like a go-to quick fix that’s regularly going down in bedrooms near you, anal Botox takes time to actually work. According to Dr. Goldstein, it takes a full week to take effect, and many patients come in for two or three sessions before full results set in: “Anal Botox lasts for three to four months, and then we usually repeat, depending on the patient, two or three times to get the maximal benefits.”
Aside from the logistical inaccuracies, the reaction Neil Patrick Harris’s character had to the prospect of anal Botox perpetuated some unfortunate misconceptions about the practice, “like that it causes looseness and that it’s not for those in monogamous relationships,” says Dr. Goldstein. While some anal Botox patients do complain of increased gas or bowel urgency, he adds, “You aren’t going to shit yourself.” Good to know!
(Also, not to overstate this, but an anal Botox sesh should never happen in someone’s bedroom—even if they are a sexy doctor.)
Will Botoxing your butt actually make anal sex better?
In short, “Hell yes!” says Dr. Goldstein. For people dealing with physical restrictions that prevent them from enjoying backdoor play, anal Botox can be a game changer. Not only can it alleviate the physical restrictions (i.e. being too tight) that may be separating someone from pleasurable anal sex, but addressing those physical concerns can also help you work through whatever mental anxieties may be interfering with your plans to get busy in the back.
According to Dr. Goldstein, successful anal sex is all about getting both your butt and your brain to cooperate. Botox can help with the butt part, which may just be the key to getting your brain on board as well. “It allows someone to work through their inhibitions and set the stage mentally for success,” he says. In other words, knowing your body is physically ready for anal sex might help you feel more mentally prepared, too.
That said, anal Botox isn’t for everyone. It may not be the best option for some people with GI issues, for example, while others simply may not need it to achieve their desired results. For some, using toys and dilating on their own is enough to get there without involving any needles.
To determine whether anal Botox is the right move, Dr. Goldstein says patients first go through a formal evaluation, which includes full internal and external exams followed by something called an anal manometry test. “With proper examinations prior to administration, we can see where and how Botox can benefit someone,” says Dr. Goldstein.
Whatever your anal sex goals are—maybe you just want to be able to enjoy more comfortable backdoor play with a well-endowed partner, or maybe you’re someone who’s into big toys or fisting—anal Botox can play a huge part in getting your body ready for action. It’s a super common practice, one that can legit help people experience the kind of sexual pleasure they want to explore.
Contrary to Uncoupled’s unfortunately kind of shamey representation, there’s absolutely nothing weird or scary about supporting your sexual desires with medical intervention. Whether or not you decide to give anal Botox a whirl, what you do with your own backdoor is your business, and there’s absolutely zero shame in it. If a date ever tries to Botox your butthole in their bedroom, though, definitely GTFO of there.
Kayla Kibbe (she/her) is the Associate Sex and Relationships Editor at Cosmopolitan US, where she covers all things sex, love, dating and relationships. She lives in Astoria, Queens and probably won’t stop talking about how great it is if you bring it up. Follow her on Twitter and Instagram.
