I'm considering Botox as my next option and was wondering whether it's best done under sedation or just in the doctor's office. Are there higher success rates with sedation?

I wouldn't think there would be a difference in effectiveness. I asked my doctor where he injected me and he said all over so they might do more injecting with sedation because they don't worry about the patient's comfort. Who knows. I had a fissurectomy each time as well so it wasn't an option but I don't think I would've been brave enough without it anyway.

I don't think I would be brave enough either. But I would like to avoid having to go through the whole sedation process. It's a dilemma.

For me the worst thing was the enema I had to do before the surgery and then the bill for outpatient surgery. Sedation doesn't effect me and I'm always quite happy and talkative when it's over. They must put something happy in the IV ) The stress from having it done at the doctor's office would be far worse. Of course it also depends on how you handle sedation and if you're having anything else done. Before my 1st surgery my sphincter was in almost constant spasm so in office procedure would've been out of question. If you don't have this issue then it is something to consider. There are some posts from people who had it done so look at those.

I had Botox yesterday with sedation. I was SO scared but it was absolutely fine! Was sort of awake but sort of not if that makes sense. I remember going in and then him starting the injections but I was super chilled and he said 'very cooperative' so I think the sedation must really help as I think the injections are very painful.
What I wondered was...how long before the Botox 'kicks in' and relaxes the muscles. I feel exactly the same at the moment...!!!
Does anyone know?!

Some people feel relief in just a few days. I was told botox peaks at 2 weeks so I expected the same but it took several more weeks. The spasms were shorter immediately for me but the dull ache continued for about 6 weeks and then it stopped. My fissure didn't completely heal but the spasms didn't come back when botox wore off either. Everybody is different so don't compare yourself to others or you'll drive yourself crazy like I did. I think a lot depends on the severity and how long you've been dealing with it. And of course how your body heals and responds to treatment. Good luck!