Am I Doomed?
The short answer is, “no”. But, what should you do now?
When a cleft lift fails – meaning that either the incision came apart and isn’t healing, or a new cyst, sinus, or wound has developed – it is usually because the cleft-lift failed to flatten the entire cleft, a new fold developed since the operation, or that the incision from the cleft-lift ended up in the midline.
Fortunately, this can be repaired by revising the cleft-lift. The revision will flatten the lower portion of the cleft and bring the incision away from the midline. This is usually successful in salvaging the situation. Of course, nobody wants another operation – but it is better to just get this taken care of then letting it linger. If six weeks or more has elapsed since your cleft lift, and you are still dealing with problems, then it is reasonable to be evaluated for a re-operation.
Who should do this re-operation? You should make sure that it is a surgeon with a broad experience in re-operating on failed pilonidal surgery and failed flaps, since there is a unique skill-set needed for this. At the Evergreen Surgical Pilonidal Clinic, we have had extensive experience with this kind of re-operative surgery and are happy to see patients who have had failed surgery elsewhere. In our clinic we have had to re-operate on about 3% of our patients, but many of these had already had previous failed operations and/or wounds next to the anus, and were in the most difficult categories of pilonidal disease to treat.
THIS WEB PAGE will show you the difference between a successful and an unsuccessful cleft-lift. The takeaway being that although many surgeons call their procedure a “cleft-lift”, there are various degrees of quality and success based on the surgeons experience and expertise.
Dr. Immerman has published an article describing the technique of repairing a failed cleft lift, and shown the results in 76 patients over a 10 year period. The article is available online, and can be viewed by following this link.
If you’ve had a cleft-lift and it has failed, don’t give up. Contact us for help!