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.
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
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
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
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 for loss of control, lessened sensation during penetration, or just that added “pucker” to the aesthetics
Relaxation with scar revision if difficulty with defecation and/or penetration
Botox injection for primary healing of secondary procedures and assisting in the relaxation of both native skin and muscle
External skin and scar revision with both excision and laser/cautery application
Symmetrical surgical alignment with contralateral symmetry
Below is the general recovery timeline from the procedure:
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.
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.
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.
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 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 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’s 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.