Those Pesky Anal Skin Tags

You were told you had to live with them. No you don't. Takes only minutes to get rid to them in the office. Your path to a gorgeous bottom. Surgical video for mature audience only. You are warned.

Perhaps the fastest growing surgery I do is removal of external anal skin tags.  Perhaps not as glamorous as doing a Barbie Look Labiaplasty but certainly in high demand. 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!  Watch this short video and take a look below on how I accomplish this in my Dallas and Vegas locations.  I teach this in my training programs as a core procedure to master. My discussion below will begin with excision (cutting), then use radiofrequency shrinkage, then laser excision and vaporization.

Irritating and ugly to the patient. Her colorectal surgeon said NO to removal because they were purely cosmetic. These are so very very common. With few places able to handle the problem.
You really want to keep those?!

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. We decided on a simple excision/cutting then suturing the edges.

I used an ultra precise radiofreuqency device (Ellman Surgitron or Soniquence) to remove the finger like projections.
Sometimes you have to suture them closed using standard cautery, radiofrequency, or a knife.

It looks simple enough to do. But your surgeon has to know how to numb up this area well or else it will be incredibly uncomfortable. Take a look at the steps below:

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. This is how most clinics and colorectal surgeons manage these. Recovery from excision, suturing, and possible scar formation is not fun. It takes about 6-8 weeks to recover.

Here is another photo set of a simple excision with rapid recovery:

One little finger sitting on the floor and causing tugging.
Simple radiofrequency excision immediately after.
Anal tags are all gone at about 6 weeks.

Some cases I can completely vaporize using radiofrequency if you have the right tools and training. Here are a couple of photo sets below where I used a ball tip radiofrequency to shrink away the anal skin tags:

Before Surgery with firm and old anal skin tags.
The anal tags and perineum were shrunk down with the radiofrequency ball tip and the entire area smoothened.
Just 5 weeks later and it looks completely smooth.

Here is a more impressive case using the same tech and same techniques:

It was ugly to the patient and not attractive to her partner.
Radiofrequency was used to feather and shrink down these areas including the perineal body (region between the vagina and anus).
It gives a gorgeous shrunk down look with pink brand new skin.

Now let’s get more advanced and show you the results of using a very special laser device. The patient below had a moderately sized anal skin tag nobody wanted to remove. I used the LightScalpel CO2 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. No scars the huge majority of the time and more comfortable than when sutures are placed.

Below, I used the LightScalpel again which has become the standard in my practice. I do not need to use much, if any, suturing because it controls bleeding very well. The Best Tool for this problem! Worth it! The recovery is more comfortable too!

Here is another example below with several “fingers” poking out and removed with the LightScalpel laser:

Hard to clean and something just kept pulling.
The LightScalpel removed the skin tag and shrunk up the tissues.
8 weeks later the tissues have pulled in and have healed beautifully.

This impressive one below is huge and called a “Cauliflower lesion” because it spreads out and looks like cauliflower. The next two picture sets show the Before/Immediately After/After. Comfort is achieved using ice packs, numbing cream, Motrin/Advil, and perhaps some mild narcotics like Tylenol #4, Dilaudid, or Vocodin. To speed up the healing process I like to use Exosome cream with Hyaluronic Acid. It is awesome.

Took 2 months to heal and look gorgeous again. Normal pale pink tissues and no more pulling in her underwear. And she felt cleaner too.
I not only removed the anal skin tags but also did tightening of her vaginal opening at the same time.

One last set below of another Cauliflower lesion I took care of at the time of her vaginoplasty and perineoplasty to give an overall petite and feminine look:

Tools of the Trade

One slim box that does not take much space, one smoke evacuator. Ready to go.
We do them all awake, completely numbed up, and in the office. This is my Las Vegas location called “Aesthetic Revolution.”
The most precise surgical laser made. You can use a wider 0.8mm spot size, to 0.4mm, to 0.25mm for char free cutting.
One handpiece that can be dialed in precisely.
The most precision is with the 0.25mm point size for exceptionally fine surgeries. Awesome for face lifts, eye brows, labiaplasties.

How much does it cost?

It is actually quite reasonably priced. The fist anal skin tag is $1500 and each after is an additional $300. The most you will pay is $2400. That covers the anesthesia too!

How do I get in?

Call the office, set up a phone/FaceTime/Zoom or live appointment. Send in your photos securely if it is a virtual appointment. Fill out the forms my staff send you and I review them and see if you are good to go for an in-office procedure. If you have high anxiety or medical issues needing a higher level of care we will do your procedure in the surgery center. You have to pay for the surgery center costs. Your follow up with me will be in 6-8 weeks after surgery either live and in person or virtual and online.

Forms I use

This is the Form to fill out before speaking with me. Pretty simple. Remember to take photo to send securely to us. The other two are the Consent and Post Op Instructions.

1a H&p Aesthetic Short Form Update 2023
87.5KB ∙ PDF file
Download
Download
This is the consent my staff and I review with you completely.
This is the Post Op Instruction Sheet to help with your recovery. You will be given my Private Patient Phone number that goes directly to me.

I hope this has given you a good idea of what we offer in Dallas and Vegas. Go HERE for more cases to view.

Red Alinsod, MD (red@alinsodinstitute.com, www.alinsodinstitute.com)

DALLAS OFFICE
Alinsod Institute Dallas
Women’s Wellness Institute of Dallas

Preston Sherry Plaza
8201 Preston Road Suite 520
Dallas TX 75225
Phone: 214-442-0055
Emergencies; 945-900-7576
Fax: 214-442-0056
Contact:
Dian: dian@womenswellnessinstitute.com


LAS VEGAS OFFICE
Alinsod Institute Las Vegas
Aesthetic Revolution Las Vegas

9130 W Post Road Suite 100
Las Vegas, NV 89148
Phone: 702-360-6686
Contact:
Dian: dian@womenswellnessinstitute.com

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