HoleTox: An incredible name for the drag daughter of Detox, sure, but so much more interesting than you’d ever imagine.
HoleTox, the branded name for anal Botox, is a service provided by Chris Bustamante, DNP, NP-C, and a leading Aesthetic Nurse Practitioner.
Bustamante’s Lushful Aesthetics clinic in NYC offers this empowering procedure to members of the gay community and beyond, as HoleTox not only alleviates bottoming pains but can prevent real issues that impact anyone: such as anal fissures.
Bustamante spoke with So.Gay about the many medically-sound reasons to sign up for HoleTox, how happy returning recipients always are, who makes a good candidate, and even delves into the “quick” experience of what it’s actually like to get HoleTox.
So.Gay: So when did this procedure originate, and what are the essentials to know about it?
C.B.: I like to differentiate. Holetox is essentially a trademark name for anal Botox. So HoleTox came to be about three years ago.
I started my practice three and a half years ago. But anal Botox has been on the market for over 20 years. There’s over 20 years of literature on anal Botox, mostly for its efficacy for treating chronic anal fissures, as well as anal spasms, and also helping patients to recover from anal related surgeries.
In more recent studies, there’s also evidence showing it’s helpful for treating hemorrhoids by relieving a lot of the excess pressure. HoleTox really was a movement for us to utilize anal botox in more lifestyle approaches… For people who have been struggling with what I categorize as ‘generalized anal tightness.’ I’ve met people who struggle with something as simple as bowel movements. At other times it’s to assist with receptive anal sex. So that is a contributing factor for a lot of people. They have issues with getting a fissure, getting a hemorrhoid, all these other things. HoleTox for three years, anal botox for 20.
So.Gay: What are some of the ways in which this procedure is alleviating pain not just for bottoms, but also folks that aren’t using it for sexual purposes?
C.B.: I mean, in the bottoming community, it’s just such a game changer. I think when you talk to enough people about sex and their sex lives, you learn a lot. It’s not just as simple as “like, okay yes, there are plenty of bottoms who struggle with always being able to receive.” It’s more complex than that.
There’s also plenty of people who identify as being tops for the simple fact that they can’t bottom, right? You’ll see the same thing on the urological side; it’s all anal health-related. There are people who are bottoms because they struggle too much, whether it’s physically or psychologically, to maintain or achieve an erection. Sometimes, where people struggle medically, it will kind of alter their sex life. They feel like they have to change it up because they’re not able to sort of meet these expectations society has set for them. HoleTox is really allowing people to feel empowered. They’re able to do what they want to do without restriction, no pun intended, with a restriction!
I see how it’s changing people’s lives a lot in that way. I talked to my medical director, Dr. Carlton, who’s pretty big on Instagram. He was a really big, influential physician during the time of the monkeypox epidemic and was just educating lots of the community on vaccinations. He talks a lot about PrEP and DoxyPep. We both agree that HoleTox is really this new preventative health treatment. I kind of categorize it in the same category as PrEP and PEP because if it’s a treatment, it’s going to prevent you from getting a fissure, from getting a hemorrhoid related to anal sex. I feel like it belongs in that category with our community.
So.Gay: Great that you’re raising awareness about issues we face and are offering a way to work in overcoming them.
C.B.: Yes, yes, exactly. Giving people options, right? Which is the most empowering thing you can do.
So.Gay: Since you see so many folks in your clinic, who makes a good candidate for a procedure like this?
C.B.: As long as the patient is generally healthy, they should be good to go. I’m talking no active infections down there and has no known neurological disorders that Botox would be a contradiction for. Then they qualify.
The dosing, in terms of how much Botox is administered, has a very big range, and it’s administered based on assessment. Through assessment, we’re looking at different indicators such as age, general status in terms of the person’s like fitness level, and more.
The more muscular, more toned someone is, the more Botox they will generally need. People don’t realize, but when they work out and do squats, they’re clenching their butthole. It’s no different than when you’re stressed and you’re sitting there at your desk and you don’t even realize it. You’re hunched over and you’re grinding your teeth. All those muscles are tightening up, and they become very, very engaged, and people will tend to tell you they have TMJ pain.
This is no different from, like, the stress of grinding your teeth. A lot of people, when they’re stressed or when they’re working out, they’re squeezing their butthole. I’ll inject anywhere from 50 to 140 units of Botox for someone. Every now and then I’ll get someone in their 50s and 60s coming in for this, and I already have a lot of those patients coming in for other procedures. For mature folks, I usually go a lot lower on the dose because those muscles generally tend to weaken as we age versus someone who’s in their 20s, early 30s. Those muscles are tight, and we account for that.
So.Gay: In your clinic, is this a common procedure, and what have you seen the benefits be afterwards?
C.B.: In my clinic, I do about three to five of these a day. It’s quickly become one of our most popular procedures. In my practice, our most popular procedures are penis filler, scrotum filler, and HoleTox.
It’s very much a sexual aesthetic, sexual wellness-focused clinic. I think that now, with more people kind of learning more about it through press, and through social media, it’s being destigmatized. Also, now it’s pretty cool; people are telling their friends about it. I’ve had people say, “My friend came in here for this, and they said it really made a huge difference for them. Like I want to try it.” And I was like, “Great!”
I think that it’s no different than the rise of PrEP, right? People in the community hear out for medical professionals, but sometimes you want a friend who’s like, “Oh, you’re doing it too? Okay, cool.”
We’ve seen an average of 83% growth in HoleTox year over year. And HoleTox now represents 37% of our total revenue, which is up 26% from last year. It’s a pretty growing treatment, let’s say that.
So.Gay: It’s fairly affordable compared to a lot of treatments. Can you talk about some other reasons why this is a reasonable thing to consider getting?
C.B.: I wanted to keep it affordable so that everyone has access to it. I think that it is at that price point that most people can afford it, obviously with budgeting. Of course, we have procedures that are a little bit more expensive on the filler side.
But I really felt like this is just something that you don’t want to miss out on because of money. I didn’t want it to be this overly expensive thing because of access. People do typically need this two to four times a year, depending on their situation. So it is something they constantly need to keep doing. But it has that benefit of really improving the quality of their life and helping them to adapt to the lifestyle that they’re looking for.
It’s such a game changer. Everyone comes back for it. This procedure is what people come back for and what people want to repeat. Basically, people come in, they get their treatment done, and they already have their next appointment scheduled for three months. Everyone’s coming back for it because they can’t imagine their sex lives going without it anymore. They’re like, “Why should I have to struggle to have sex when I don’t have to?” I think that’s a big game changer for people.
So.Gay: Tell us about the procedure itself? How long does it take?
C.B.: It takes three minutes to do, like actually, like three minutes. I give the patients a little bit of laughing gas, which most people don’t do. I just think it takes the edge off people being nervous, because it’s not a painful procedure. So the internal sphincter is what will be injected first and I use an anoscope to inject it. So you slide on in, put lube all over [the anoscope], slide on in, pull that out, needle goes through here, and I inject the internal sphincter. You actually don’t feel the internal injections. Then we inject the external sphincter… Those quick little pinches and you’re done.
So overall, it’s a really fast treatment. A really comfortable treatment, there’s no pain afterwards. You’re not like lingering around like, “Oh my god, my butthole hurts.” None of that. So in three minutes, it’s basically done. I block off 30 minutes just to make sure in case someone’s late. I’m also planning on talking to them for about seven minutes or so just to make sure I’m educating them, answering their questions. Then when they come back for repeat treatments, the appointments are 15 minutes in and out.
People sometimes refrain from doing some of these things because of fear of pain. Now that’s just not something they have to worry about with this procedure at all. I’m super transparent when it comes to what people can experience regarding pain. I tell everyone: lip filler is the most painful thing you can possibly do in aesthetics, in my opinion. So if you’ve handled that, everything else is a walk in the park. So HoleTox is virtually painless, three minutes in and out.
So.Gay: It is interesting that this procedure’s been around for 20 years. That should prove its efficacy, right?
C.B.: Yeah, it’s kind of actually the best situation. It’s worth noting that there are 20 years of literature on its efficacy and its safety margin, right? Botox itself has a higher safety margin than Advil, which is pretty crazy. We know that this medication works for this area already, but now we’re just kind of approaching it differently. We’re approaching it from a lifestyle perspective and like a functional preventative medicine perspective versus just direct treatment after things go wrong.
Why should someone have to go through it, get hurt, and all that stuff to figure it out? We can just prevent it from the beginning. Same thing that we’re doing with PEP, right? So it’s like preventing STI.
You can visit their Instagram @LushfulAesthetics to learn more about the procedure, and to see before and after images and videos.
For uncensored content on HoleTox and more, visit Twitter @LushfulAesth and YouTube Channel.
If you visit the New York office, be sure to share you heard about HoleTox from So.Gay!
