Do people usually get the LIS surgery at the time they are suffering in pain due to a fissure OR after it's already healed and just want to prevent it from ever happening again? I'm confused about when the right time is to have it done.

I think the right time is when you simply can't stand it for another second, and have exhausted yourself with other remedies. I went for three years with unbearable pain before I finally broke down and had LIS. Once it was over, I thought to myself, "You colossal jackass, why did you wait so long?!?" The surgery was a snap. Went to sleep on the operating table, and then I woke up and it was over. I took pain meds for a day, and after that I only took Tylenol for the next couple of days, and then nothing. First bowel movement was completely pain-free, and all bowel movements since then have been pain-free. I'd say that if your fissure has "gone into remission", I would leave well enough alone, unless it comes back again. If you are in pain right now, my vote would be to go and get the LIS at your earliest convenience, but get it done by someone who has at least a couple of hundred LIS surgeries under his belt. SUCCESSFUL LIS surgeries, I might add. My surgeon was a general surgeon (not a rectal specialist), but he had performed a couple of hundred LIS, and came highly recommended.