Performing anilingus on a woman while fingering her vagina. Similar to a rusty trombone.
That bitch is so hot, I'm gonna give her the rusty ukulele.
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The opposite of the Rusty Trombone, in which the recipient is female. Basically, the male (or female) licks the receiving girls asshole while fingering her.
Man, she gave me a Rusty Trombone so I had to return the favor. I spun that bitch around, got down on my knees and gave her a Rusty Milkbox Ukulele.