There’s a buttload of money in anal rejuvenation.

Just ask Dr. Evan Goldstein, a Manhattan surgeon who has pioneered the practice of making buttholes beautiful and more sexually compatible through Botox, tightening and loosening procedures.

“It’s kind of crazy. I did not think I would be playing with ass all day, that is for sure,” Goldstein told Moneyish. As a gay man, Goldstein, who began his medical career as a cardiothoracic surgeon, wondered how he could help his community. He noticed that most doctors performing anal surgery were treating hemorrhoids or cancer but “were not looking at the anus as cosmetic or sexually functional,” he said.

So he opened his Bespoke Surgical practice on East 12th Street in 2010, where he offers medical services to treat hemorrhoids, skin tags and fissures, as well as cosmetic procedures like Botox, dilating and tightening services, that run from $5,000 to $25,000 depending on the severity of the case.

“Sometimes people come with really bad booties,” said Goldstein.

And he’s not the only surgeon specializing in these niche procedures: Dr. Norman M. Rowe, who practices in New York and New Jersey, uses noninvasive radiofrequency energy to heat and tighten anal tissues and Los Angeles-based Dr. Zuri A. Murrell offers anal rejuvenation and bleaching services and treats hemorrhoids, skin tags and polyps. Many of these cosmetic issues stem from something medical, which means that patients may find insurance covers their procedures.

That was the case for Joseph, 45, who asked to speak to Moneyish under an alias. In February, Joseph was treated for a hemorrhoid he’d suffered with for five years. “It was unquestionably a medical issue. I wasn’t going in and saying, ‘Hey, tighten things up and make them look pretty,’” he said — but noted, “that was definitely an added benefit. I love it. Everything looks normal again.”

Best of all, the procedure has also rejuvenated his love life. “I had sex with my husband, and it’s like, ‘Wow – I’m 20 years younger!’” he said. “This is not a stretched-out ass. It’s back to how it was when he met me 13 years ago.”