By the way i love your Avatar, it is scarier than mine! Ha Ha. I can't take that damn bag off my head yet....

Perineum swelling is probably from some of the botox injections...or it's just normal. Those body fluids will go where the least resistance is. After my surgery (LIS and hem'ectomies....) 10 days post op I developed a "knot" like swelling in the perineum. But, since I have no fever and the swelling isn't warm to the touch, I'm not worried. I have noticed that the swelling is more spread out in the early mornings, then by the end of the day it is more concentrated and noticeable.
If the swelling is uncomfortable you can try my homemade concoction. Buy some party balloons....the clown balloons ended up being too thin and long. Stuff balloon with some cotton or tissue, and 2 parts water, 1 part rubbing alcohol. Knot it up and stick in the freezer. Experiment with different balloons and different amounts of stuffing to get the size that its down there just right. You can wrap it in a gauze 4x4 or a very thin sock if it feels cold to your skin.
I found the cold pack after a hot tub bath to be just about right.
I too have gotten sick of my tub. So, I bought a candle and put a small nightstand that fit between the tub and toilet. All I need is right there. I also began to limit my time to 15. I keep three books by the tub. I've learned several ways to "sit" in the bath, two or three positions on my back, and even lying on my left side.
Hang in there.

Update: Day 9 - So when I said in update Day 8 that the boot up the arse feeling wasn't as bad, I guess it didn't feel too bad because it was abnormally late in the day for a BM (9pm) and I'd gone to bed sitting on a hot water bottle. When I woke up at 3am needing a wee (tepid water bottle), I realised I was still in a 'booted state'. Was tough to get back to sleep.
Woke up this morning, slightly later and later each day as I'm out of my usual 6am routine for work, I got up, took a Movicol and tucked into my one lonely Wheatabix, but by the last bite I was running to the loo, spoon in hand to have a BM.
Fell out, (Bristol 6) no pushing, stinging feeling afterwards probably because the fissure does not like the watery loose poop being all up in its face (I don't like it either, so why should my fissure). Onto the Bidet. Arse wedged in, Tap digging into my thigh. So relaxing. :roll:
NOW I was ready to start the day... well apart from the booted up the bum feeling again. My mum was adamant I should put a cold pack down there as it seems swollen. I read on here somewhere that someones Doctor didn't consider this to be a good thing and told them off. (Any ideas?) 
Well I had it on there for 10 mins and by-jove it worked. Pain disappeared. I guess it takes the swelling down, but am I doing damage as I should be warming it up to get the blood flow down there for healing.
Pain relief Vs Healing?

Well I got up and ready to leave the house finally, theeeeeen I needed to poop again. No trouble with this one either, Less pain I guess. Booted feeling came back.
Went out for a bit, walked around Asda (on a SUNDAY? What was I thinking?)

Not really been too uncomfortable all day which is great. Bought some Vitamin E as it apparently aids tissue repair.
Still no blindingly obvious signs of Botox. Is it working? Who knows? I should... that's who!

My nan made me a cake the other day when sh found out I was in hospital and I couldn't eat it. She's now going to make me a "Bara Brith" (Welsh traditional fruit loaf) which in my eyes is lots of raisins & Sultanas maybe some sugar too. That's good for me bowels right? in desperate need of some comfort food.
Momof7 You made my drink come out of my nose when I was reading your Balloon concoction, I had no idea where you were going with it at first, maybe balloon animals? Waaaaaaah Ribena everywhere!
Rachael if you every find yourself without a toilet, you've always got a paper bag to rely on!

Chew the raisins very very well!
=)

I just skimmed through the posts, so sorry if this doesn't fit completely.  I saw 'unable to heal without surgery' and wanted to comment.  I am months into a very large AF and was given "minimal" chance of healing (with the ointments and diet).  I'm not a 'success story' but have seen very gradual improvement over weeks/months.  I don't know what others have found, but I have found very, very slow gradual natural improvement.  Not for everyone (if I had known six months ago what I was dealing with I may well have opted for LIS....or at least botox).   But just wanting to keep the conversation going.

Hi DWF, your posts are hilarious! Talk about having a sense of humour whilst being in Fissure hell. I love the bit about Asda. Yes I could poop in the bag, I would poop in hell if it guaranteed I would be Fissure free. I really hope that you can heal, and get your life back. Don't lose that great sense of humour. This Forum is a godsend. Xxxx

" I would poop in hell if it guaranteed I would be Fissure free" 

I think this is quite possibly my favourite quote of all Fissure quotes. Thank you Rachael. You have made my day. 

Update: day 10 - woke up, Movicol, wheatabix with grapes, pint of water. 2 Bowel movements within half hour. 
No real pain, not much stinging. Butt in the Bidet then a cheeky ice pack. 
Perenium was probably a bit more swollen a few days ago and now the skin is just a bit puckered. 
6hours later... I can sit. No pain. What a relief. 

So I can keep this routine up for one more week (movicol, lots of water, lots of rest, my own comfortable toilet, a sitz on demand) but next week it's back to work. This is where it'll get difficult. I'd like to reduce my Movicol down to once a day eventually and then maybe half a day. 
I'm trying not to think about it but with the impending need to get my tush prepared eventually for...
larger stools (oh the horror). 

All I can say is, in my current state, I'm really glad I went through with the surgery. This had been a real fight. At one point I think I was on the cusp of depression with other things in my life but I can finally see the light at the end of the tunnel. There's a long way to go but it's there. 
Aaaaand I'm looking forward to some Chilli Sensations. 

That's really good to hear WDF sounds like things are improving nicely for you, so pleased.
Do you get any pain at all after your bm? I'm taking lactulose & magnesium before bed & have 1 or 2 bm in the morning usually within a hour of getting up I then have a warm bath, no pain during bm (stools are very soft & easy to pass) but I still get pain after wards that persists for several hours & its over 4 weeks since  my surgery, I'm really niggled by this as whilst i can happily lay on the sofa once kids have gone to school & amuse myself with day time TV I will have to go back to work eventually & at the moment the thought of that fills me with dread!! In the past 12 months i've had 3 seperate procedures to try & sort this out (Botox, then LIS, then fissurectomy & more botox) I'm honestly starting to think I'll be stuck with this blooming thing for ever!! Argh!!!!

Don't despair Jilly, everyone's different, sounds like you've had a lot more trauma to your tush too. I've had 4 years of the fissure going chronic to a point of tears.
I'm on 2 Movicols a day, chewing my food to within an inch of its life - possibly back to its original form as an atom, then guzzling more water than I've drank in my life, although I could probably eat various things, I'm sticking to a basic basic diet. No junk food.
My last 2 BMs today (out of about 11 BMs in total) were pleasant, I did have pain afterwards but the ice packs really really helped.
Yesterday's BMs were pleasant too (slight sting) and gave me a (hard to explain exactly) numb, dull ache with pressure. Is this the same pain? A booted up the bum feeling? Are you getting any pain whilst having a BM?
Are you keeping your to a diet? Plenty of water? Try an ice pack to sooth it, although sitz baths help with getting blood to the area to promote healing, if the pain is too much, try an ice pack which will bring the swelling down.
Stay positive Jilly, take it easy, like I said we're all different. I personally don't feel like I had these "spasms" that people are taking about, I'd have a razor blade feeling, then a soreness. I can't put my finger on a spasm feeling, unless that's the sore feeling itself?
Chin up and keep fighting,
Welsh x

HI WDF,
So glad i could bring a smile to your face. wow i made your day!! We have to keep a sense of humour through this, or we may end up insane.I know that booted up the Butt feeling, i get it lots, the worst is when i also feel like i could poop myself. I think this is the Botox relaxing everything back there. Not sure if that booted feeling is the damn spasms. When i have healed(God knows when that when will be) i don't ever want to hear the word Fissure again.....