More and more people are getting Botox every year in an attempt to halt or even roll back time. But did you know that some gay and bisexual men are getting injected below the belt?
Some men are getting Scrotox — where Botox is injected into your scrotum for both aesthetic and medical reasons — and others are getting anal injections.
It’s called HoleTox, and it’s gaining popularity among gay and bi men who are looking for ways to make bottoming even better.
But what exactly is HoleTox, and would you consider getting injections in your anus if it meant better sex?
What is HoleTox?
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HoleTox (a.k.a. anal Botox) is on the rise, but it’s still a fairly niche procedure where neuromodulators like Botox, Dysport, Jeuveau, and Xeomin are injected into the anal sphincter muscles, allowing them to relax.
This makes bottoming easier by reducing or eliminating the initial sting and allowing your anal muscles to relax during sex. It can also improve anal fissures and anal spasms, which can help make receptive anal sex less painful.
“Functionally, it’s also used for individuals who experience tightness that limits their ability to experience pleasure while bottoming, as it can help the muscle become more accommodating over time with regular dilation exercises,” said Dr. Evan Goldstein, the leading anal health expert in the United States who founded Future Method, a sexual wellness brand dedicated to revolutionizing anal sex prep. “We also use it for people who want to go bigger, like larger toys and fisting, but are limited no matter how much they train their asses.”
So if bottoming is your thing, but you hate how long it takes you to relax before the real fun can start, HoleTox might be worth a try. Aesthetic Nurse Practitioner Chris Bustamante, who is also the owner and CEO of Lushful Aesthetics, perfected and trademarked HoleTox, but doctors across the country are performing anal Botox.
“The ideal candidate experiences tightness or discomfort with receptive anal sex (bottoming), difficulty relaxing the anal area, or chronic anal fissures or anal spasms,” Bustamante explained. “Anyone dealing with these issues can benefit. People usually seek treatment to improve comfort. As long as there are no active anal pathologies or major health disorders, most people are candidates to proceed.”
How does HoleTox improve your sex life?
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Getting anal Botox or HoleTox improves comfort and pleasure while bottoming because it relaxes the anal sphincter muscles and allows for reduced tension, resistance, and pressure, while also decreasing pain and micro tears.
“Primarily, HoleTox makes the experience less painful,” Bustamante said. “Indirectly, it often makes it more pleasurable — because when pain and resistance go down, the overall experience improves. Patients commonly say things like: ‘I can finally relax,’ ‘It feels easier and more natural,’ and ‘I’m not bracing myself anymore.’”
According to Goldstein, your best bet for making bottoming as enjoyable as possible is to couple anal Botox with anal dilation exercises.
“For many patients, that relaxation allows the tissue to adapt more effectively over time, especially when combined with proper dilation exercises,” he said. “As a result, bottoming can become less painful and more comfortable, and in some cases, more pleasurable simply because the body is not reacting with protective tension. It’s important to note that outcomes vary by individual, but the overall goal is to create a safer, more functional environment that supports both comfort and desired activity.”
Is HoleTox becoming popular among gay and bisexual men?
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Bustamante said that the desire for HoleTox has been growing steadily as queer men start to seek out more of these types of sexual wellness treatment.
“HoleTox has exploded amongst the gay/bi community, and it’s still early,” he said. “Conversations around sexual wellness are becoming more open and men are more willing to invest in quality-of-life procedures. There’s crossover from aesthetics into sexual/functional health and it's really making a major impact on people's quality of life.”
While HoleTox and anal Botox can be used to improve post-operative recovery and help with anal fissures, gay and bi men are getting it more and more to make bottoming easier and more enjoyable, especially if you like to go big or go home.
“It just takes that spasm or elevated pressures away, allowing one to better prepare, dilate, and engage,” Goldstein said. “Another use is for those looking to get into bigger toys, fisting, and/or larger penises. So, for those who regularly engage in anal play, Botox in the sphincter muscles has been a game changer that more and more people are learning about and coming to see us for.”
How much does it cost?
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At Lushful Aesthetics, Bustamante charges a flat rate of $900 for HoleTox, but other clinics charge between $1000 to $1500 for anal Botox, depending on how many units are needed. If you are getting it for a medically necessary reason, like anal fissures, your insurance will likely cover the cost, but you’ll probably pay out of pocket if you’re getting it to make bottoming more comfortable.
While results typically only last three to five months, Goldstein said that some patients get maintenance treatments going forward, but some only get a few treatments to reset their bodies, and then they don’t feel the need to continue.
“Many patients find that periodic injections help them maintain comfort and flexibility, especially when integrating strategic dilation techniques,” he said. “Most people do two or three rounds of treatment and then, if accompanied with anal dilation and intercourse, it doesn’t require any further treatments. However, people may like it since it helps psychologically and we can continue, but for many, it resets the pressure and then boom, success.”
What are the side effects?
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The most common side effect is slight pain at the injection site, feeling like you have more gas during recovery, or minor trauma from the needle that can cause a small hemorrhoid, although that can be treated easily with topical creams and suppositories. And if you’re prone to hemorrhoids, you can do preventive treatments before you come in for anal Botox.
The most important thing is to do your research beforehand and choose a reputable doctor or injector to minimize the risk of side effects.
“The risk people often mention is whether people will experience incontinence,” Bustamante said. “While that is technically possible if you fully paralyze the muscles, I've never had it happen. It's all about understanding the medication, the anatomy, patient history and making assessments. The treatment is quite predictable in experienced hands.”
The procedure itself only takes a few minutes, pain is minimal, and you can return to normal activities quickly. “The external injections feel like a quick pinch that immediately resolves with no residual discomfort,” he said. “We advise three days of no anal play/sex. HoleTox sits at the intersection of sexual wellness, functional medicine, and preventative medicine. It's a game changer for improving people's confidence and quality of life.”
Sources cited:
Dr. Evan Goldstein is the leading anal health expert in the United States who founded Future Method, a sexual wellness brand dedicated to revolutionizing anal sex prep.
Aesthetic Nurse Practitioner Chris Bustamante is the owner and CEO of Lushful Aesthetics, who perfected and trademarked HoleTox.
