Is cosmetic anal surgery (anal tightening, rejuvenation, or skin tag removal) safe and effective?

Name: Is cosmetic anal surgery (anal tightening, rejuvenation, or skin tag removal) safe and effective?
Published: 2026-10-05

In adults seeking anal surgery for cosmetic or 'rejuvenation' reasons (including anal tightening procedures and removal of perianal skin tags for appearance rather than symptom relief), what are the complication rates, continence outcomes, recurrence rates, and patient satisfaction compared with no surgical intervention?

Compiled 2026-10-05 · checked 2026-10-05 · next 2026-11-05 · automated review, how it works

Bottom line

No study has tested whether cosmetic anal surgery — tightening or skin tag removal done purely for appearance — is safe or effective.

All 6 studies found involve people having similar surgery to treat a medical problem, like anal fissures, hemorrhoids, or sphincter damage from a childhood operation, not healthy adults who want the area to look different. Their results cannot be assumed to apply to someone having surgery for appearance alone.

How certain

Very low

The 6 human studies found measure a related question rather than this one, so they can only be read indirectly.

What it shows

Not studied

No study has measured this outcome in people with this condition.

studies found: 6studies found
randomised trial: 1randomised trial
people studied: 940people studied
years covered: 2008–2021years covered

What the research shows

Postoperative complication rate (bleeding, infection, stenosis)
No study measured complications in people having anal surgery purely for appearance. Studies of similar surgery done to treat anal fissures or hemorrhoids report few complications, but those patients had a disease being treated, not a cosmetic goal.[1,2]
Not studied
Fecal/flatus incontinence after surgery
One small study found bowel-control scores unchanged after surgery for anal fissure. Another describes a sphincter-tightening technique for children with incontinence from a different condition, but reports no outcome data. Neither tested cosmetic tightening in adults with normal bowel control.[1,2]
Not studied
Wound healing time
In a small study of surgery for anal fissure, most wounds healed within three to six weeks. This describes healing after disease treatment, not a cosmetic procedure done on someone without a fissure.[1]
Not studied
Recurrence of skin tags or recurrence of aesthetic concern
Low recurrence of skin tags was reported after hemorrhoid surgery, and no recurrence at 12 months after fissure surgery that used a skin tag flap. Both groups had surgery for a medical condition, not to remove tags purely for looks.[1,2]
Not studied
Patient-reported satisfaction with appearance or symptoms
High satisfaction was reported after hemorrhoid surgery and after fissure repair, but these patients were being treated for a painful or prolapsing condition. No study asked people having surgery purely for cosmetic reasons how satisfied they were with the appearance result.[1,2]
Not studied
Need for repeat surgery
In one small study, 2 of 15 patients needed a second procedure to finish healing after fissure surgery. This was in people being treated for a fissure, not people having surgery for a cosmetic goal.[1]
Not studied

Important limitations

None of the 6 studies enrolled adults seeking anal surgery purely for cosmetic reasons. They studied people being treated for anal fissures, hemorrhoids, sphincter damage from childhood surgery, or vaginal (not anal) tightening after childbirth.[1,2,3,4,5,6]
Most studies are small case series without a comparison group, as few as 2 to 15 people, so there is no way to know whether the outcomes seen would have happened without surgery, or whether they apply to people having surgery for appearance instead of disease.[1,2,3]
The only randomized trial found measured how fast numbness set in during anesthesia for anal surgery. It did not measure complications, recurrence, or appearance results at all.[1]
One study is about vaginal, not anal, tightening surgery. It is included only because it is the closest available evidence on a similar 'tightening' type of cosmetic procedure in that body region.[1]

Why people try it

Wanting the perianal area to look smoother or tighter, often after noticing skin tags or looseness.
Marketing from cosmetic or aesthetic clinics advertising 'anal rejuvenation' or 'tightening' procedures.
Hoping a tighter-looking area will improve confidence or sexual satisfaction.
Comparing themselves to images or claims seen online or on social media.

What the studies found

Found a benefit5 · 83%
Mixed or unclear1 · 17%

What kind of studies

Case series5 · 83%
Randomised trial1 · 17%

The studies that decided it

Krois et al. 2021
A technique to reconstruct the anal sphincters following iatrogenic stretching related to a pull-through for Hirschsprung disease
Describes technique only, no results given.Case seriesVery low qualityRelated question
2 people2021
describes a surgical technique used in two patients to improve bowel control, without reporting outcome data
Who was studied
children with fecal incontinence after Hirschsprung disease surgery due to overstretched anal sphincters
What they received
sphincter tightening surgical technique to repair overstretched anal sphincters
Compared with
no comparator described
Main outcome
improvement in bowel control
Quality
This is a report of only two patients describing a surgical technique, with no outcome data or comparison group, so it cannot show whether it works.
Limitations
Only two patients described; no outcome results reported; this is for a different condition (sphincter damage from Hirschsprung surgery) not cosmetic anal tightening in otherwise healthy adults.
Taken word for word from the abstract
- n we report two such patients
- population patients with overstretched sphincters and loss of the dentate line after an initial pull-through
- intervention describe a sphincter tightening technique to improve bowel control
- comparator the treatment of this true fecal incontinence is limited to a structured bowel management program with ante- or retrograde enemas to achieve social continence
- primaryOutcome improve bowel control
- result Herein we report two such patients with overstretched sphincters and loss of the dentate line after an initial pull-through and describe a sphincter tightening technique to improve bowel control.
J Pediatr Surg · PMID 33358008 · Read it on PubMed ↗
Wu et al. 2020
Vaginal delivery combined with vaginal tightening surgery and perineal body repair: 5 case reports
Improved sex life, no complications reported.Case seriesVery low qualityRelated question
5 people2020
all wounds healed well, no complications, improved sexual function and increased pelvic muscle strength scores
Who was studied
women giving birth vaginally who also had vaginal tightening surgery and perineal repair
What they received
vaginal tightening surgery plus perineal body repair performed alongside vaginal delivery
Compared with
no comparator group
Main outcome
wound healing, complications, sexual function, and pelvic muscle strength after surgery
Quality
This is a tiny uncontrolled case series of only 5 people, so it cannot reliably show the procedure works or is safe.
Limitations
Very small sample size, no comparison group, retrospective analysis, and this is vaginal (not anal) cosmetic surgery.
Taken word for word from the abstract
- n 5 cases underwent vaginal delivery combined with vaginal tightening surgery and perineal body repair
- population 5 cases underwent vaginal delivery combined with vaginal tightening surgery and perineal body repair
- intervention vaginal delivery combined with vaginal tightening surgery and perineal body repair
- comparator We retrospectively analyzed the clinical data.
- primaryOutcome there were no postoperative hematoma, infection or vaginal mucosa prolapse. Sexual function was improved to different degrees. The pelvic muscle force test showed that both the type I and type II myofiber scores were increased.
- result The incisions of 5 cases were all primary healing; vulva form was improved, and there were no postoperative hematoma, infection or vaginal mucosa prolapse. Sexual function was improved to different degrees.
Medicine (Baltimore) · PMID 31895764 · Read it on PubMed ↗
Sobrado Júnior et al. 2019
Anoplasty with skin tag flap for the treatment of chronic anal fissure
Less pain, high satisfaction after fissure surgery.Case seriesLow qualityRelated question
15 peoplemean period of 29 months (12-56)
86.7% of patients healed within three to six weeks, the other two healed after repeat surgery, continence scores were unchanged, all patients reported less pain, and 93.3% were very satisfied with no recurrence at 12 months
Who was studied
adults with chronic anal fissure who had not responded to non-surgical treatment and had normal anal muscle tone
What they received
anoplasty using a skin tag (anal plicoma) flap to cover the surgical wound
Compared with
no comparison group; outcomes measured before and after surgery in the same patients
Main outcome
pain levels and fecal incontinence scores after surgery, plus healing and recurrence
Quality
This was a small study of only 15 people with no comparison group, so it cannot show how it compares to other treatments or to doing nothing.
Limitations
Very small sample size, no control group, and the patients had anal fissures requiring surgical repair rather than being healthy people seeking cosmetic anal surgery.
Taken word for word from the abstract
- n we followed 15 patients with chronic anal fissure
- population CAF patients refractory to conservative treatment without anal hypertonia
- intervention anoplasty with the use of anal plicoma to cover the bloody area
- comparator We applied a visual pain questionnaire and the Cleveland Clinic fecal incontinence score before and after surgery.
- primaryOutcome to evaluate the long-term results of the correction of chronic anal fissures (CAF)
- result Healing occurred between three and six weeks for 13 patients (86.7%). The other two patients underwent debridement and new anoplasty successfully. No plicoma necrosis or anal stenosis occurred in any patient. The anal incontinence score did not change after the procedure, and all patients reported reduced pain. After 12 months of follow-up, none of the patients presented recurrence or anal incontinence, and 93.3% (14/15) of the patients were very satisfied.
- followUp mean period of 29 months (12-56)
Rev Col Bras Cir · PMID 31432983 · Read it on PubMed ↗
Spanos 2012
Anal skin tags: removal made simple
Simple technique, minimal pain reported.Case seriesVery low qualityRelated question
size not given2012
minimal pain was noticed in patients undergoing this procedure
Who was studied
patients with anal skin tags undergoing stapled anopexy for benign anal disorders
What they received
removal of anal skin tags using the circular anal dilator from the stapling kit and cautery
Compared with
none reported
Main outcome
pain experienced after the procedure
Quality
This is a small descriptive case series of a technique with no comparison group, no patient numbers given, and only a vague pain outcome.
Limitations
No number of patients reported, no control group, and the procedure is done alongside stapled anopexy for anal disorders rather than as a standalone cosmetic skin tag removal.
Taken word for word from the abstract
- population Anal skin tags are a common finding. They are found in one-third of patients with bening anal disorders.
- intervention Skin tags are brought through the perforations of the circular anal dilator of the stapling kit. The skin tags are removed by cautery.
- comparator We describe a simple method of anal skin tag removal during stapled anopexy.
- primaryOutcome Minimal pain has been noticed in patients under going this procedure.
- result Minimal pain has been noticed in patients under going this procedure.
Colorectal Dis · PMID 22646711 · Read it on PubMed ↗
Liu et al. 2010
The effect of warmed ropivacaine to body temperature on epidural sensory block characteristics
Faster numbness onset, not about surgery outcomesRandomised trialLow qualityRelated question
180 people2010
numbness came on faster with warmed ropivacaine at several levels, including the anal area with one concentration
Who was studied
adults aged 18 to 64 undergoing elective anal surgery
What they received
ropivacaine warmed to body temperature given epidurally before surgery
Compared with
ropivacaine at room temperature
Main outcome
how fast numbness (sensory block) set in during epidural anesthesia
Quality
this is a well-designed randomized trial but it studies an anesthesia technique for anal surgery in general, not the safety or effectiveness of cosmetic anal procedures themselves.
Limitations
Abstract does not report complications, surgical outcomes, cosmetic results, or long-term follow-up; it only measures speed of anesthetic onset.
Taken word for word from the abstract
- n 180 ASA physical status I and II patients, aged 18 to 64 years, undergoing elective anal surgery
- population undergoing elective anal surgery
- intervention warmed (body temperature) ropivacaine
- comparator room temperature (RT)
- primaryOutcome To determine whether warmed (body temperature) ropivacaine increases the speed of onset of sensory block of epidural anesthesia.
- result Mean onset time of T12 and L3 sensory block was significantly faster for each BT than RT ropivacaine concentration. Anal region (S4, S5) sensory block was significantly faster after BT 0.75% versus RT 0.75% ropivacaine.
J Clin Anesth · PMID 20304352 · Read it on PubMed ↗
Wang et al. 2008
A modified Ferguson hemorrhoidectomy for circumferential prolapsed hemorrhoids with skin tags
Few complications treating prolapsed hemorrhoids.Case seriesLow qualityRelated question
738 people13.2 months
few complications, low recurrence of skin tags, high patient satisfaction
Who was studied
adults with grade III or IV prolapsed hemorrhoids and skin tags
What they received
modified Ferguson hemorrhoidectomy surgery
Compared with
other radical surgical methods (not detailed with data in this abstract)
Main outcome
complications and recurrence after surgery for circumferential prolapsed hemorrhoids
Quality
This is a single-center case series without a randomized control group, so the good results could be due to other factors.
Limitations
No randomized comparison group, retrospective-style review of treated patients over 15 years, and this is a disease-treatment surgery not a cosmetic procedure.
Taken word for word from the abstract
- n A total of 738 patients (mean age, 43 (range, 19-83) years) were treated with our modified Ferguson method
- population 576 patients had Grade III and 162 patients had Grade IV hemorrhoids
- intervention We describe a modification of the Ferguson hemorrhoidectomy for circumferential prolapsed hemorrhoids.
- comparator compares the results of other radical methods in patients with circumferential hemorrhoidal disease
- primaryOutcome Postoperative bleeding occurred in 16 patients, 3 of whom required surgical hemostasis.
- result Only three patients had recurrent skin tags, which did not affect their quality of life.
- followUp The median follow-up was 13.2 months in our outpatient department.
Dis Colon Rectum · PMID 18213490 · Read it on PubMed ↗

What actually helps, on this site

More about the condition:

All 6 studiesEvery study that answered the question, with its design, size and result.

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.

Searched: PubMed · ClinicalTrials.gov · Crossref on 2026-10-05
The exact search — paste this into PubMed to repeat it: ("Anal Canal/surgery"[Mesh] OR "Anus Diseases/surgery"[Mesh] OR "Perineum/surgery"[Mesh]) AND (cosmetic[tiab] OR aesthetic[tiab] OR rejuvenation[tiab] OR tightening[tiab] OR "skin tag"[tiab] OR "skin tags"[tiab] OR elective[tiab]); PubMed expanded that to: ("anal canal/surgery"[MeSH Terms] OR "anus diseases/surgery"[MeSH Terms] OR "perineum/surgery"[MeSH Terms]) AND ("cosmetic"[Title/Abstract] OR "aesthetic"[Title/Abstract] OR "rejuvenation"[Title/Abstract] OR "tightening"[Title/Abstract] OR "skin tag"[Title/Abstract] OR "skin tags"[Title/Abstract] OR "elective"[Title/Abstract])
What came back: 316 records found · 200 read · 6 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
Limits: Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

316records came back from the search
200were read
6actually answered the question

Risks and safetyReported side effects and who should be careful.

In surgery done to treat anal fissure or hemorrhoids, few complications were reported, but these patients were being treated for a disease. Complication rates specific to cosmetic anal surgery in healthy people have not been measured.
A small case series of fissure surgery reported that 2 of 15 patients needed a repeat procedure for the wound to fully heal.

Common questionsShort answers, drawn from the same studies.

Is cosmetic anal tightening surgery dangerous?: This hasn't been tested in people who want surgery purely for appearance. Related anal surgeries done to treat disease report few complications in small studies, but that doesn't tell us the risk for a cosmetic procedure in an otherwise healthy person.
Will removing anal skin tags for appearance come back?: No study has followed people who had skin tags removed purely for looks. In people treated for hemorrhoids or fissures, tag recurrence was low, but those people had a different anal condition to begin with.
Does anal tightening surgery affect bowel control?: This specific question has not been studied in cosmetic surgery patients. In one fissure study, bowel-control scores stayed the same, but those patients had a different anal condition, not healthy anal function.
Should I go ahead with this surgery?: That's a personal decision, but you should know that no published study has measured complication rates, satisfaction, or results specifically for cosmetic anal surgery. Ask your surgeon for their own case numbers and complication rates, since the research can't answer this for you.
Is there a non-surgical alternative I should try first?: None of these studies compared surgery to no surgery, so this review cannot tell you whether waiting or skipping the procedure leads to a different outcome in appearance or symptoms.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

Contact the office

Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.