Perhaps the fastest growing surgery I do is removal of external anal skin tags. Early in my career I would remove a few per month and now it is several every week. No one wants to do them. Gynecologists, Urogynecologists, Colorectal Surgeons, Gastroenterologists all pretty much run away from them. The problem is that they are considered a cosmetic problem, difficult to get insurance approval to remove, and the compensation for removal is exceptionally low. Plus, you need specialized expensive equipment, such as a laser or radiofrequency device, to succeed in this type of practice. No one wants to buy a $20,000 to $85,000 machine, spend an hour of surgical time, and get paid less than $200 for the case. As for me, my machines for labiaplasty and vaginoplasty work well for anal skin tag removal and so our practice booms with fair pricing and improvement of the patient’s quality of life. No more pulling and adjusting and discomfort and tough times cleaning. And it looks beautiful too. I do not like it when I create a beautiful labia minora, majora, clitoral hood, perineum and then look down and see a large piece of skin from the anus poking out at me. I want the entire perineum and perianal area to look gorgeous! Take a look below on how I accomplish this. I teach this in my training programs as a core procedure to master.
Above is a typical patient with external anal skin tags that protrude out, is difficult to clean, and is not very pretty in her eyes. It used to be a bleeding hemorrhoid, showed up during pregnancy, got large, then shrunk to this. She had no bleeding, and her gastroenterologist did not find any internal hemorrhoids. The G.I. and Colorectal specialists declined to remove these and told her she had to live with it.
I used radiofrequency to excise and shrink the anal skin tags and placed sutures to control the bleeding and align the edges. This is a traditional excisional technique and can be done with regular cautery also. No expensive tools.
The patient above had a moderately sized anal skin tag nobody wanted to remove. I used the LightScalpel laser and excised the skin tag, shrunk the tissues around it to cause it to pull inward, placed no sutures, and it healed without a trace.