I wouldn't know what to suggest my CRS advised to try the LIS first as with the amount of times I can go he thought the stitches from the flap surgery would be put under strain and it could cause infection, but he did say that is my next option if this doesn't work. My fissure was deep to the muscle and very long (too long to cut the full length) it only healed less than 10% with the Botox but 6 weeks after LIS had healed 30% even with one of my worst IBS flare ups in a while.
I was convinced I wasn't healing but I was. I'm going back in 2 weeks and he did say that if I'm healing he wouldn't consider the flap surgery even if I'm only healing slowly. Again I have big issues, sometimes even if I starve myself I will have burning hot liquid stools so that May have an impact on why he would leave the flap surgery until I'm not healing anymore.
Listen to your docs as they know you best and every person is different my CRS specialises in IBDs so his experience of these surgeries is mainly with IBD patients.

My consultant is advising me to have the LIS depending on the results and he said a skin flap would be the last resort, but my first consultant was dead against the LIS and said a skin flap would be best it's really hard hearing 2 different consultants! The thing that sways me to the LIS is that it has a 90 % chance of healing it which is the highest and long term helps with any new fissures that come along as the skin flap might tear open or it light heal but won't help me if I get another one later down the line... god I'm so confused today lol

Why exactly did he say not to have the LIS, if you have a tight sphincter surely you will keep getting new fissures if you do t have the LIS unless your resting tone is low then yes the flaps are the best and safest option...have you had a pressure test yet Hun I can't remember?
It's hard when you have conflicting advice, some surgeons can tell your resting pressure without a test maybe your new consultant thinks you have low resting tone and that flaps are best.
Not sure if the severity of the fissure is relevant though I know mine was very bad but flaps will be a risk for me even more so than the LIS.

my other consultant doesn't do the LIS because of the incontinent risk and because I am young with ibs, but my new consultant said that will only be a problem later on in life and that a skin flap would be his last resort! he is sending me for the pressure testing so just a waiting game now just cant decide to go with him or just ring my other consultant up and book in the flap? I know when im stressed and anxious by bum will naturally go tight and spasm slightly so surely the LIS would be better? im just worried about what suzy said that it will never heal because of the scar tissue so a skin flap is the only answer

In LIS they don't cut the muscle very much it's more like a they knick it. Too much and things would be too loose. It's a great procedure for most people but it doesn't always work. As far as advancement flaps go, my friend had the closed flap with IBS and she's doing just fine. She also had LIS that didn't work.

So she didn't have any stiches come out at all? Does she have a problem with straining and her ibs as that's what I'm worried about more I guess. How long is recovery for the procedure, I think because my fissure isn't that big anymore he thought that a skin flap at this stage isn't necessary

She had what is called a house advancement flap. Ask your doctor or you can look it up. She's doing fine almost 9 years since she had the surgery but she still takes miralax daily.

ok thanks hun

So having a few bad days, I'm in a lot of pain when I'm going to the toilet and all day, I seem to be having the runs constantly which is making me go 3 or 4 times a day I don't know if it's a bug or my ibs and anxiety playing up but can hardly eat anything either without it upsetting me my wound has torn and looking really red I am so fed up it's unbelievable! What does everyone do when they have an upset tummy because I'm scared to get constipated if I don't take my stool softeners or if I take something to stop the diarrhoea but I don't want to aggravate it either?

Oh nooooo hunii, that doesn't sound good,
Can you perhaps lay off the stool softeners....I know you might panic but my CRS said that diarrhoea can actually cause more harm than constipation, especially if your fissure is really active as it's easier for stool to get in there and if it's acidic then it burns big time. I'm sure your not going to go from diarrhoea to constipation especially if your going like 4 times a day Hun.
Other than that you could try marshmallows or jelly babies my friends with colostomies are advised to eat these to slow down output...I do try them and it can help but not if I'm having a bad flare only if I'm going less than 6 times.