Hi Edel,
Sorry that you have had a recurrance. Great that you have had such a long time pain free. I too have had a round of botox but just 6 weeks ago. It is still possible that you may get relief from the last round of Botox. Your tear may be causing more problems than the previous one. Have you got absolutely no relief or is it slightly improved? Having read other posts have you addressed your diet, fluid intake and post BM hygiene.?
I have re-introduced the GTN ointment twice daily to try and keep the sphincter as loose as possible. My CRS has said that while Botox is a chemical attempt to loosen the sphincter and promote healing the LIS is a constant release which will ensure a much better chance of healing. As I have also learnt that when a fissure becomes chronic it is less likely to heal by chemical or topical means. Remember that this forum is usually frequented by those of us who have not been healed yet. There are thousands more who have had uncomplicated LIS or Botox procedures that have healed completely and have no use of a forum like this.
I wish you healing XX Pia.