By now, vaginal rejuvenation, or labiaplasty, a procedure that tightens areas that have become slack from experience or childbirth, is pretty well-known. In that vein, I want to bring up something I’m sure most of you haven’t heard of, and it’s—are you ready for it?—anal rejuvenation. Think I’m pulling your leg? I assure you I’m not. As you probably assume, this surgery has to do with your butt; more specifically, it’s supposed to make your butt prettier. Medically speaking, the procedure involves removing extra skin to tighten an orifice that is suffering “overdistention.”

Let me save you a Google search and define overdistention; basically it means one’s sphincter is no longer as tight as it once was. It’s apparently such a prominent issue these days that Vice interviewed doctors about its growing popularity. “I’m looking at the symptoms [patients] developed and what’s going on internally and externally…and what pathology is associated with that,” Dr. Evan Goldstein, a leading anal rejuvenation practitioner, told Vice.

He emphasizes that many of the aesthetic concerns of his patients, who are mostly gay males, can be evidence of undiagnosed medical problems like hemerrhoids, anal warts, abscesses and even cracks in the anus. Goldstein, a gay man himself, estimates that nine out of 10 procedures performed at his private practices in Los Angeles and New York City are anal rejuvenation. Another noted rejuvenator, Dr. Zuri Murrell, says his office’s anal procedures account for a fifth of business.

These procedures aren’t cheap, either. Another noted rejuvenator, dermatologist Dr. Jessie Cheung, uses laser treatment to resurface and tighten the butt. How much would something like this cost, you ask? Only $1,500 to $2,500.

Goldstein, whose practice experienced a boom about five years ago, explains that after this procedure, patients generally experience a few days of pain and some exceptionally painful bowel movements. Then, during follow-up visits, Goldstein will have patients test their new butts with a selection of toys to make sure that everything has healed correctly and patients aren’t experiencing any abnormal pain from anal play. From start to finish, the patient should be back at it in the boudoir in two to three months.

Also available under Goldstein’s umbrella of eccentric butt services? Anal Botox, a procedure that paralyzes the sphincter muscles, making it easier to take something…let’s say girthier. In fact, a man’s size proved the prominent need for the anal rejuvenation. Most patients cite that they’ve been with men in the past who are too large and now, they can no longer achieve pleasure with their new partner.

On that note, if you think this is only a gay man’s problem, you’re dead wrong because anal sex is growing rapidly among heterosexual couples. Research in the Journal of Sexual Medicine found that more than one third of women have tried anal sex. Thirteen percent had done it within the last year of the study.

Even straight men are beginning to see the appeal. Research from sex-toy manufacturer Lelo found that 75 percent of straight men in a relationship have tried or admitted they’d like to try prostate massage. So guys, butt sex is here whether you like it or not.