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Anal reconstruction focuses on restoring the form, function and cosmetic appearance of the anus. We’re an elite anal surgery practice that specializes in anal reconstruction based in NYC. Visit our office or give us a call today to see how we can help you.

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Table of contents

The anus is a delicate part of the body with a variety of functions. Whether you’re addressing a medical issue or needing anal reconstruction, Bespoke Surgical is ready to answer your questions in this thorough guide to anal reconstruction. We’re an elite anal surgery practice with an emphasis on wellness based in NYC. Read ahead to see if you might qualify for an anus reconstruction.

What is Anal Reconstruction?

Anal reconstruction is a type of plastic surgery that focuses on restoring the form, function and cosmetic appearance of the anus. These reconstruction services may also help tighten the sphincter muscles that are too elastic and beyond recoil. There are a few different names for anal reconstruction, including anal plastic surgery, depending on the purpose of the operation. Anal reconstruction will revitalize the anus’s aesthetic look and functionality, increasing the patient’s quality of life.

Is Anal Reconstruction Right For Me?

If you are interested in getting anal reconstruction surgery, it’s important to understand if you can qualify as a candidate. It is designed to help you not only regain muscle definition and tone, but also create an aesthetically pleasing exterior all in the hopes of enhancement, both physical and mental. This procedure may be right for you if you have ever experienced:

  • Dissatisfaction with anal appearance
  • Loss of control during intercourse and/or defecation
  • Overuse of the anal muscles
  • Anal tearing, hemorrhoidal disease, and extra skin tags regionally

If you’ve had problems with your anal musculature being too loose, consider checking out other services such as our anal elasticity program before diving into anal reconstruction surgery. There are also specific services for issues such as anal skin tags, if you’re not looking for an overhaul.

Please note that this surgical option is available to members of all gender and sexual identities as anyone who struggles with the issues outlined above can benefit from treatment.

Anal Reconstruction Benefits

Anal reconstruction addresses structure, elasticity, appearance and more. This surgical procedure is uniquely beneficial because it promotes physical and sexual health simultaneously. With anal reconstruction, you can regenerate wellness and sexual pleasure that you may have lost.

The benefits of anal plastic surgery can also include:

  • Restored anal function, elasticity, & strength
  • Improved appearance
  • Tightening or relaxation of sphincter muscles
  • Removed anal skin tags
  • Improved sexual confidence

Anal Reconstruction Procedures at Bespoke Surgical

Anal reconstruction and anal repair procedures are conducted at our New York City practice and include:

Anal Tightening

We provide anal tightening surgery for loss of control, lessened sensation during penetration, or just that added pucker to the aesthetics.

Anal Relaxation

If you have difficulty with defecation and/or penetration, we provide relaxation services with scar revision.

Anal Botox

We provide botox injections for primary healing of secondary procedures and assisting in the relaxation of both native skin and muscle.

Scar Revision

To fully rejuvenate your anal area, we provide external skin and scar revision with both excision and laser/cautery application for a clean look.

Quality Work

We guarantee symmetrical surgical alignment with contralateral symmetry.

Our services cover a range of needs from anal smoothing to cyst surgeries. We’re happy to work with you to create a complete treatment plan for your anal reconstruction.

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Initial Recovery

Below is the general recovery timeline from the procedure:

1-3 Days

For the first 24 hours after your surgery, you should not drive, operate heavy machinery, make important decisions, or sign legal documentation. You should also refrain from consuming alcohol and large or heavy meals. The first two to three days we usually disclose you won’t love us very much. Clearly a constant pain in the ass and one will utilize prescribed pain medication along with lotions, suppositories, and anti-inflammatories to assist in all facets of recovery. You most probably will need to use painkillers for the first 24-72 hours after surgery and then I recommend switching to Tylenol or Ibuprofen for the next one to two weeks.

2-5 Days

It is common to not have a bowel movement for 2-3 days after your procedure, so stay well hydrated, eating fruits and vegetables daily, and consider taking a mild laxative to help this process along. You may need to use painkillers for the first 24-72 hours after surgery. On day 3, we recommend switching to Tylenol or Ibuprofen. You will need to avoid stress to the operative site (such as lifting, pushing, and pulling) for 3-5 days.

1-2 Weeks

Epsom salt baths are a lifesaver and assist in not only the healing process, but also pain control as well. And of note, most anal procedures for full healing are around 6-8 weeks, with us seeing you two times during this period to assist in the healing process. Some specifics most clients ask:

  • Exercise Most clients head back to the gym about a week post-surgery and do limit gluteal work until all feels improved roughly two to three weeks.
  • Intercourse The majority engage by topping or vaginal intercourse in about one week. We do recommend masturbation first, making sure all works well, since during orgasm, most contract their pelvic floor and this may lead to pain. Test the waters first.
  • Water We are totally fine with pools, jacuzzis, and/or the ocean, and do believe getting active in these environments assists healing. We would recommend these activities about 2-3 days post surgery and do recommend showering directly after and following the usual post-cleansing rituals.

Utilizing a bidet can also be helpful for gently cleansing the sensitive area. To learn more about what to expect during postoperative recovery, please visit our Frequently Asked Questions.

If you have a condition that requires surgery, every effort is made to make you better than you were. Post-operative protocols help minimize scarring and increase function. Sometimes the severity of the surgery and/or your body’s healing process causes issues such as excessive scarring and fibrosis. Scaring around the anus can severely limit normal function and cause a great deal of stress and anxiety.

Treatment is effective in minimizing the effects of scaring. It can include manual and plug dilation, pelvic floor reconditioning, Botox, Cortisone injections, and more. If you have issues related to previous surgeries that you have been living with, please do not hesitate to contact us.

Understanding Anal Surgery

Most clients present Dr. Goldstein with an anal pathology that limits their life. Fissures or cuts, hemorrhoids, skin tags these things cause hindrance to sexual engagement. Of course, these physical issues need to be tended to, but with an acute understanding of maintaining ideal aesthetic and long-term functional needs, including sexual engagement. The anal smoothing aspect of our process highlights this philosophy. We understand that the area around your anus has many functions – and that you want to feel the best you can. That’s where anal reconstruction and cosmetic surgery comes in.

This particular field of science bodes heavily on the preoperative assessment and genuine understanding, the surgical knowledge that caters to Bespoke Surgical’s three pillars of form, function, and aesthetics, and most importantly, the post-operative interventions and follow up to revitalize true form and function. With several pathologies, the initial concern, injury, or trauma may have healed in a way that aesthetically is not optimal and/or the overall function has been compromised.

How We Can Help

Understanding our clients’ overall goal or goals allows a treatment approach to be tailored towards anal repair. Removal of extra skin tags and/or anal tightening of the orifice if over-distension is an issue allows for re-alignment. All anal reconstruction treatments are provided with the truest of understanding how function and form correlate with aesthetics. The world of anal surgery is beyond the operative procedure and requires a thorough understanding of how the tissue heals and later functions.

The postoperative course and follow up allows the individualized aesthetics like anal smoothing to be realized and over the ensuing months, a home remedy of dilation and anal play brings the form and function to light. Why is this important? Because sexual identity in any community is of the utmost importance and Bespoke Surgical understands this. We not only get it, but we fix it and reconstruct it.

Following recovery, we also offer a range of other services to keep your new and improved anal region in tip-top shape. Laser hair removal and anal bleaching are two grooming services we provide to enhance the overall appearance. In addition, we also have educational resources about the best practices for safe douching, proper lubrication, and more. Lastly, we encourage all of our sexually active clients to prioritize their wellness with regular screenings. Learn more about all that we have to offer here at Bespoke by getting in touch with us today!


My boyfriend fits beyond the bill for me. I have to pinch myself regularly to make sure that our relationship is actually real, since I feel so unworthy of such a magical prince. When we first met, he was pure bottom and couldn’t get enough of me inside him, but as time went on, the sensation diminished and anal play just wasn’t successful. Both he and I couldn’t reach orgasm, let alone even sometimes keep our erections. It was like he had become too loose and to boot, started to develop some extra skin in the region.

I could sense him becoming quite self-conscious, developing shame in these unforeseen circumstances. I even overheard him say to a friend, I have all the exterior looks that make people everywhere turn and stare, but I’ve lost the one beautiful thing that gave me my sensuality in private. Losing this could sacrifice not only my sex life, but also my sexual identity and even worse, my current relationship.

Hearing all of this made me search for what options may be available to help, but first I needed to figure out how to have the courage to confront him and discuss these super important issues. One night, we finally had the most amazing conversation about everything in our relationship and he was so happy that I brought it up. I told him my research led me to anal reconstruction and it seemed like Bespoke Surgical had the solution we so badly sought out.

We defined what the term anal reconstruction meant to us with his symptoms of extra skin and an increase in elasticity. Dr. Goldstein performed a same-day procedure with removal and tightening of both the muscle and overlying skin, and some superficial resurfacing to complement the symmetry. It definitely took some time to heal and then re-dilating to accept toys and of course, me. But it was totally worth it, it’s now tight, puckered, and winks when we want. It has helped our sex world tremendously and most importantly, the mental ramifications that coincided with his symptoms.


Dr. Evan Goldstein, D.O.

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical, NYC’s leading sexual health private practice. He received his osteopathic doctorate from the University of Medicine and Dentistry School in 2002 and completed his residency in General Surgery at Maimonides Medical Center. In 2020, he was named one of NYC’s top LGBTQ+ business leaders by Crain’s New York and he is involved with GLSEN, ACRIA, HRC, and Callen-Lorde Howard J. Brown Society. All of these experiences and affiliations have shaped his whole-life approach towards the practice of private surgical care and sexual wellness.

Read More    Dr. Evan Goldstein’s NPI record  Click to send an email to egoldstein@bespokesurgical.com

This page was medically reviewed by Dr. Evan Goldstein on January 12, 2023.



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