Hey Dexterdude - I haven't heard of cutting the skin, but maybe that would help.
I have heard of the dilation procedure, though. It is an older procedure that surgeons had stopped using because it wasn't as effective as the LIS and had a higher rate of incontinence. However, milder versions of it seem to be used more these days because less violent dialation doesn't seem to have the same risks as earlier methods. I'm sure a few boardies here had it done. Genevieve, from Toronto, had an LIS and a small anal stretch after that. Her story is here:
http://anal-fissure.org/t45p30-genevieve#1005I think the dilation helped her, but she still struggled with small fissures afterward. It’s not clear, though, if she possibly had another condition that caused her problems too.
I think you're definitely right to talk to him about this - especially abou the risks, and how many of these dilation procedures your doctor has done successfully. I also wonder if this cutting of the skin is like a mini fissurectomy? I also wonder why he isn't just going directly to an LIS. Would this procedure rule out an LIS in the future if dilation doesn't work. Yep... I'd have a lot of questions myself!
Please keep us posted. Maybe some folks who know more about it will chime in. Good luck with your appointment!