(Maybe this should be in the considering surgery section)
As a possible future Botox victim i am struggling to comprehend the lack of success it seems to have amongst members of this board and success rates in general.
Now i completely understand how the recurrence rates can be significantly higher with Botox than LIS but why does it not have the healing efficiency of LIS??
I see it like this - LIS involves a very small cut to the internal sphincter which reduces anal pressure allowing it to relax which in turn improves blood flow and the fissure heals. Botox completely paralyses the internal sphincter so it is completely relaxed so surely the healing rate should equal LIS?? In fact as the resting pressure is relaxed further things should heal quicker... why does this not happen?
Or is the problem with Botox the recurrence rate? If this is the case then i understand as LIS permanently relaxes the internal spincter whereas Botox wears off after three months so the re-tightening of the sphincter can cause a freshly healed wound to re-tear.
What dont i understand? Any help or further understanding is appreciated :D

Your understanding is as good as mine. I am 4 weeks fissurectomy with botox injection - at this point it's a waiting game. Feeling a bit in the dark regarding my own plan of care with my surgeon - so, i'm also seeking a 2nd opinion in 2.5 weeks . . .