Recurrence of these fissures is common, about 10 to 20 percent in my opinion, okay, and the research is all over the place, there's not a true number. What that tells me then is that surgery is not the right answer for many people, okay, and when they get their recurrence and they come into my office - because this happened before - they say "Dr. Chung, we went through this surgery, why do I have another cut again, why is this happening again, I went through a tough surgery of the anus recovery, why?" And I don't have an answer. That's one of the things that makes it so difficult for me to have this conversation, and for that reason again is why I have not done this surgery procedure since about 2017-2018, and I find that talking to the person, going over your life in detail and the habits around your pooping and your eating is by far more helpful, and the need to do a surgery goes to zero in my opinion. I've healed fissures that were there for over a year, and the knowledge that the patient has the strength to be able to get their quality of life back and to get these things to heal over and over again is by far more helpful and much more powerful than doing a surgery.