...botox + fissurectomy, not sure I've seen this one around here before
I saw the CRS today and even though I said I wanted the LIS, he told me they only do it VERY rarely, when all else fails. This is because although when they do it it has very good success rates (89-98%), there's also a pretty good chance I'll need diapers when I'm 70.
So what he recommended instead is this: we should try botox first. However, since the fissure is chronic, he said botox is a 50-50 shot and they do it alone only for acute fissures. BUT, if they would refresh the wound and take away the dead tissue, meaning kind of a fissurectomy, then the chances go up to about 75-80%. The fissurectomy would be done using laser, which is supposedly the latest thing, and would mean scraping the old tissue away or burning it, so new and healthy tissue can grow back. It's done under general though short anesthetic, so I'll be sleeping through it and it requires an overnight stay in the hospital so they can help me with any immediate pain. Then it's a week away from work and another follow-up appointment in 6 weeks. The only possible complication, he said, is pain, the chances of anything else should be minimal. He told me they have had very good results with this procedure.
Haven't got it scheduled yet, they have some paperwork to do, but I've given my signed consent so it's on. I'll let you all know how it goes

Hmm maybe I spoke too soon. I did a search and seems other members have had this in the past. Also, it doesn't look like it's a breeze, compared to the LIS, as the fissurectomy wound is left open to heal and might be quite big. The doc told me he'll give me a week off work but now I'm thinking maybe I should ask for two? I mean, going back to sitting in a chair with an open (bleeding?) wound?!
I also read a bit the documentation they gave me to sign and it says I agree that they can also do other stuff if needed during the OP. This immediately made me think of hemmorrhoidectomy...even though as far as I know I have no hemorrhoirds..who knows?! Maybe I should explicitly opt out of that one? Or any idea what other nasty and not-totally-necessary stuff they might do?

You know, I read once on the anal fissure self help page that a guy had his AF lasered SHUT. I asked my CRS about it, said he'd never heard that but if they're gonna have the laser in there anyway....
Anyway, I would ask for the second week, if you can, just until you see how you are. Some ppl are fine day after LIS, some take months to heal. Too much time off is better than not enough. Good luck I really hope it works for you and you don't have too much pain.

Thanks for the kind words. I was actually hoping to get the LIS, but all doctors here seem to REALLY have something against it as "it's too invasive" and "too permanent". Which is a good thing I suppose, but on the other hand an open bleeding wound doesn't sound that fun :)
Regarding the laser, as far as I understood, it won't close anything, it will be use to remove the scar tissue and probably the skin tag as a less invasive and more precise instrument than the scalpel.