Patient Satisfaction: The Results of 1000 Patient Surveys
We are very concerned about patient satisfaction, so we continuously survey our cleft-lift patients regarding their experience. Of course, we wish every patient was completely satisfied and that their recovery was fast and uneventful, but with medicine and surgery nothing is 100% since every patient and every operation is unique. However, we believe that our results compare favorably with any other general surgeon, colorectal surgeon, or pilonidal specialist in the world. Here are the survey results from 1000 cleft lift patients. These patients have been had their cleft lift surgery since 2009. Approximately 1280 surveys were sent out, which brought us 1000 responses (a 78% response rate, which is very high. Most studies are happy with a 50-60% response rate). You may notice that not every question has 1000 respondents – sometimes individuals chose to respond to the survey, but not to answer a certain question. These were all patients of Dr. Immerman, but we are now lucky to have Dr. Daniels in our pilonidal clinic performing the cleft lift operation with the same level of expertise.
There is a distinct difference between the kind of results that researchers and clinicians discuss in their articles and the results of a patient centered opinion survey. We feel that the most important aspect of treating patients with pilonidal disease is making the patient feel cared for, heard, and cured as quickly and easily as possible. Clinical series that give the researcher’s opinion regarding healing and appearance is important, but it is not the whole story.
I previously published a paper showing the results of the first 500 patient surveys, and it is now updated here by adding a second group of 500 patients. This is notable in that there’s nothing in the medical literature that matches the scale, patient-reported detail, and single-technique focus of this series. The results of this new 1,000-patient survey now makes this the largest cleft lift patient-reported outcome survey anywhere, and essentially the only one with enough time and volume to confidently break results down by satisfaction, perceived difficulty of recovery, cosmetic satisfaction, and patients’ opinion of the appropriateness of the cleft lift operation.
Patient’s Free Text Comments
The survey had an is opportunity for comments along with the other choices. You can read some of them by clicking on the following link.
Patient"I was so done with surgeries. I'm from Virginia but went to see Immerman. I was HEALED in 10 days. I felt so stupid going through all these other surgeries when Immerman literally fixed me in like 30 minutes. Also, it's the most comfortable surgery. The surgical center is gorgeous, the staff are so friendly, and they even send you home with a meal and even feed your driver. The follow-up is great and the pain is minimal."
This may be the most important question of the survey, and it shows that of the 1000 patients 97.6% were Satisfied or Extremely Satisfied with the cleft lift procedure. This is an exceptionally high satisfaction rate. For a disease process with worldwide failure rates often cited as high as 30–70%, this level of satisfaction is extremely rare. In spite of this extremely high satisfaction rate, the 5 patients with continued problems bothers us – and we continue to strive for 100% satisfaction. Unfortunately, these patients with healing problems often have additional dermatologic or autoimmune diseases that impede the success of the cleft lift.
Patient"When I realized how relatively few surgeons do the cleft-lift procedure (I didn't find anybody in my state), I anticipated it would be very difficult to schedule an appointment with a cleft-lift surgeon out of state and expected that it would take on the order of a few months to be seen. I cannot overstate my amazement that after I initially contacted Dr. Immerman's clinic I had an appointment scheduled (and ultimately my surgery was completed) within about TWO WEEKS. The staff was exceptionally professional and organized. They knew exactly what to do to make the process of scheduling an appointment for a patient out of state so straightforward. Evergreen Surgical is exemplary and should be a standard by which health care, in general, is measured. I cannot overstate just how impressed I was by their level of professionalism, organization, and compassion."
The vast majority of patients felt the recovery was Very Easy, Easy, or Better than I expected (87.4%). Only nine patients out of a thousand respondents felt that the recovery was “Really Hard”, indicating that the recovery process usually goes very smoothly.
Patient"This was a positive choice because I had little recovery time and I’m 100% cured and very satisfied with minimal scarring. I was very relieved that I was feeling so much better so quickly. It was much easier than I thought it was going to be during recovery."
One of our goals is to get patients back to normal activity with few restrictions as quickly as possible – and the survey responses indicate that we were successful. Only 3% of patients felt it took a long time to get back to normal activity. Here are more details on the activity restrictions we suggest after a cleft lift.
It is important to note that 45.8% of the patients indicated that this was their first operation, while 54.2% had undergone previous failed surgeries. This shows that this was not a group of easy patients, but a mix of primary and revision cases. The high satisfaction rate holds across both groups, even in notoriously difficult revision cases.
When we asked the patients who had previous failed surgery, the majority indicated that they wish they had a cleft lift first. It is unfortunate that we included a “Other” category, because it clouded the numerical data. However, almost all the patients who responded with a written response were positive about the cleft lift, and were so incredulous that it wasn’t everyone’s first choice, that they had comments that went far beyond the options provided!
This is similar to the previous question, but is only for patients in whom the cleft lift was their first operation for pilonidal disease. Again, the vast majority were enthusiastic about this choice. This is a very important issue, as there are many surgical options for pilonidal disease. If our patients felt that the recovery, restrictions, success rate, or appearance were too difficult – this was their chance to let us know that they regretted their choice. Other than 6 patients who feel they should have tried something else first, the remainder were positive about their choice.
One of the few reasons that we feel a patient should not choose a cleft lift, is if they can not tolerate the change in appearance of the gluteal crease or the length of the scar. In answer to this question, 90.8% of patients were OK with the appearance, and another 7.7% were philosophical about it, and agreed it could have been worse. It should be noted, that over half of these patients had undergone previous failed operations, and the scarring, distortion, and infection from caused by the other operations does effect the ultimate appearance of the cleft lift. Here is more about the cosmetic aspects of a cleft lift.
Only about 15% of our patients live close by, and the remaining 85% have traveled significant distances to come to us for care. We feel that this is a reflection of how disruptive pilonidal disease can be, how poorly it is managed in other clinics, and how our reputation gives patients faith that we will take care of them and solve their problem.
Free Text Answers
There were many, many free text answers that patients provided as they filled out these surveys. All of these written comments were analyzed by Chat GPT-5, which included 225 pages, and over 1000 written comments. That analysis shows that the open-ended responses echo and validate the statistical findings and offer rich narrative evidence that patients feel:
The cleft-lift should be first-line treatment
The Evergreen Surgical team sets the gold standard in communication, coordination, and care
Patients choose to travel, pay out of pocket, and wait weeks because the outcomes are that transformative
This is not just surgical success—it’s restoration of normal life after medical failure.
In Summary
The Evergreen Surgical Pilonidal Clinic produces outstanding patient satisfaction, short recovery times, and minimal lifestyle disruption. The myth that cleft lift should be “last resort” is debunked by overwhelming patient support for its use as a first-line treatment.
These results should serve as a wake-up call to surgeons still advocating midline excision or non-definitive treatments. The data show:
Cleft-lift is safe, effective, and durable
Patients overwhelmingly regret undergoing alternative procedures first
Appearance and recovery are not deterrents
By searching the internet one can find that this is the largest and most definitive patient satisfaction survey ever conducted on cleft lift surgery—and possibly in all of pilonidal care. With results that are not just statistically significant, but they are clinically transformative for our patients.
Patient"Surgery went great and I feel much better than before having it. Having the ability to do the consultation and surgery on the same day was very convenient as I traveled 9 hours for the surgery. The staff and Dr. Immerman were very helpful and knowledgeable about pilonidal cysts and the Cleft Lift and I felt very comfortable with everything he did. I would recommend him to anybody with this problem."
