Hoping for some reassurance and first-hand feedback


This is my first time posting here and I just wanted to say right off the bat that its a really fantastic website.

I got pilo about 4 or 5 years ago, probably due to sitting on my arse all day studying and eating all the wrong things. I got it diagnosed about half a year ago and I have the op coming up in early June. Recurring infection, bleeding and the fact the sinus seems to be growing means that they suggested surgery, even though I'm not really in any pain at all (something which i now appreciate is very good fortune).

The procedure they've recommended is the Karydakis. The consultant I saw implied it was just a minor little op (something which I'm starting to doubt since doing my research). In and out the same day. Inspite of my doubts, I guess I have to trust him as the expert; the fact that he said this was his teams preferred procedure seems promising. Plus the website seems to promote this procedure over the others due to the decreased recovery time and reoccurrence.

I just want to say I know what I'm about to ask may seem extremely vain. I know I need to have some sort of operation because I cant keep having recurring infections all my life. There may also be an element of 'Whoa there fella, too much information!' but then I guess this website was built for those suffering of this disease to ask questions and get answers.

I'm just worried about the cosmetic implications of the 'cleft lift.' See, im a 21 y.o. gay guy and as silly as it may seem im just worried that its going to turn my my rather nice bum (if i do say so myself, well besides the stinking pilo :p) into a bigger source of insecurity then the pilo ever was. I'm just worried that after the op i'll be stuck in the same situation im in now where its holding me back from ever 'going all the way' but this time instead of the pilo holding me back, it would be the fact i would have a cleftless, flat, deformed bum (no offence intended to anyone, this is just me talking about my fears). I'm also worried that i may not be able to move around as freely as i do now. How does the operation restrict your movement (if at all)? I can just imagine it would seem tighter in the area. I love to run and play tennis; how long from experience do you think it will be before I can continue after the op?

I have more questions but those are the main ones.

I would greatly appreciate any words of wisdom on the matter and even more, I would appreciate any reassurance you could offer. I'm getting some preoperative jitters heh. Thanks for taking the time to read, but for those who couldn't make it:

[TL;DR] Questions regarding cosmetic implications of Karydakis: Do you have any cleft left at all or is it totally flat down there? I play Tennis and like to Run. How long do you think it will be after recovery until i can continue? Any reasurance to sooth pre-operative jitters welcome. Cheers

Alex :)

It's been a while since I have been on here.

I had a cleft lift. I can't remember how different it is from the standard karydakis (if that is what you are having). It is a small op and if everything goes well you will be out the same day. My body didn't cope well with the anaesthesia so I was kept overnight.

If you can find my thread, you can read about post op healing. I took it easy but was back at work 2-3 weeks later, as I didn't want to take any risks. I still had to have days off due to soreness, which ended up being from an undissolving stitch that was causing friction and not allowing the bottom of the wound to heal. Once that was removed, it was plain sailing.

As for the butt question, if you read my post you will see I was a bit depressed about it too. I was young, with a nice bum and suddenly reality hits you that it's not going to be the same anymore. It IS different. The top part of the cleft (which was shallow anyway) is now flat and there is a straight scar in its place. It does change things a bit however, I don't even think about it any more and can't remember what my bum was like before to be honest!

I only remember that my bum is different when there is a reason too! I was actually just trying to do some ab exercises but lying on the floor with my scar pressed on the ground is painful, which is what lead me back here today.

After living with pilo for 5+years, I wish had done the surgery sooner, even with its implications. Just be happy and confident and you will find these things aren't a big deal - we make them get in the way!
I had the cleft lift and the only different to my butt (everyone says its nice too :p lol) is the scar and the 'wound' atm. But no difference is shape/look etc.

"How long do you think it will be after recovery until i can continue?"

I think it depends on the person and how you heal. I thought i would heal quick, but 16 weeks later its still leaking badly everyday, getting infected and still cant sit/lay properly. Yet a person who sits about 10 metres away from me had exactly same thing about 2 weeks after me, and he was fully healed after 4-5 weeks.

You shouldnt need to worry about the op, i didnt (but thats me in general never worry about anything lol), i wasnt in any real pain after, its just akward if you wanna go in a car to docs or shops, but get used to sleeping on your side or front for a while! Just take it slow and dont rush the recovery.

As stopit, i managed to get a while off work, around 5 weeks off, then 2-3 week part-time, the nurse's seemed sympathetic, so i got longer than i needed i think, but in reality in about 2/3 weeks relaxing should be fine
Apparently there's a difference between a Karydakis and a cleft lift (I thought they were the same thing from the information on the website). Going by what the consultant said, I don't think what I'm having is a cleft lift as from memory he said that there will be a scar but it will be inside the cleft anyway so not noticeable unless you pull the cheeks apart lol! I also spoke to a med student friend of mine who reassured me that it was a fairly simple operation and that things shouldn't change to much configuration-wise heh.

I appreciate both of your replies though. I sleep on my front anyway heh. I really do need to get in touch with work though and let them know about the op. I only found out the day I posted this thread that I was booked in. I'm not sure what my recovery time will be but I'm planning on dragging my desk over to my bed so i can carry on revising, gaming and staying in touch with the outside world in general lol. Any other pro-tips that can only be learnt through experience? heh
I think the modified karydakis and the cleft lift are essentially the same. I'm just not sure how the incision and stitching is different in the regular karydakis, but if you're not losing your cleft, that's great. I had no idea which surgery I was going to have as the consultant said they would make the call after seeing how extensive it was.

I have to say though, even the GPs and my husband who was then a med student didn't actually know anything about Pilo surgeries. They don't know the ins and outs of the techniques and are more often exposed to the simple open/closed excisions. As far as I know/remember there is going to be more of a physical change with something like the cleft lift than a straightforward closed excision. But I'd rather take the changes because they came along with quick and thorough healing and thankfully, no reoccurrence.

Good call on the desk. I did the same - fellow gamer here too :D. sitting on my arse all day playing games as a teenager might have something to do with the pilo ^_- actually it started when I started uni and was travelling on train/tube daily. Spent as much time as poss on the bed on my tummy or side. Walking around was okay but was careful to walk slowly so as not to disturb 'stuff' too much. Started sitting after a few days and got one of those pilo cushions with the cut out for my chair.

Good luck!
Well, im under the knife tomorrow. Feeling alittle nervious but thats mostly in anticipation of the recovery pain and injections then the actual operation. I hope everything goes well heh. Anyway, thanks again for all of your replies. Alex
Update. Nobody warns you about the wait for the operation. Its horrible, eslecially when your as nervious as i am. Just sopke to the surgeon and apparently i shouldnt expect to have much of a cleft left after this which actually makes me feel really sad. Its like im loosing a feature of myself. Probably sounds silly to most. Anyway... back to the waiting i guess.
The waiting game is the worse. As sad as it is the cleft lift will make your life easier, and although change shape thr PS will notbe as degrading for you. Good Luck. Keep us updated.
Alex, what happened? How did it go? Is the shape different? I hope it went well and you're not self conscious about it. My daughter is having hers next week.
Hi Melbourne Mum, how was your daughters op? I'm having the karydakis soon so would be grateful if you could let me know how it's going? I'm quite nervous about the recovery. I have to say this website is brilliant for finding out information though!
Hi Cherry,
My daughter is recovering rather slowly I'm Afraid. I may not be the best person to ask at this time. It's 2 weeks today since the surgery. She's found it quite painful. The bottom has been draining blood and fluid for the past two days. The top part is healing well. She's ok today but some of the people on here have amazing stories - like a week and back to work! She's definitely not sitting or moving around much. Sorry!! I will check back in a few days with hopefully better news. Ellysparkles had a great surgery with Dr Bascom and has been extremely helpful.
Thanks for the update! Yes, that kind of recovery is what I'm expecting really. The surgeon has made out like it's a really simple thing and I'll most likely be back to work in a fortnight. Bearing in mind I have a desk job and a long commute on a busy train I think that quite unlikely! I'm trying to stay positive about it but its really hard!
I know exactly how you feel. However, she is still really pleased she had it done. I just cleaned it and it was closed. There doesn't appear to be fluid draining tonight so perhaps that has stopped. She is in far less pain today also, in fact has not asked for any pain relief at all today!! Her surgeon said 3-4 weeks healing and hopefully that's still on track. I don't know where you are in the world but if you are in the US then Dr Bascom is the go - check the Hall of Fame. As long as your surgeon has done 200+ of these ops - my daughter had the modified Karydakis which also involves a cleft lift then you will be fine.
Apparently fluid draining is common. I think Elly said that her Dr said of these ops, 50% open slightly top or bottom and of those, 90% close by themselves. So you'd be pretty unlucky to be the 5% that requires further surgery.
It's definitely a very scary place to be in the beginning and thank goodness for this website.
It's the most frustrating condition because it seems like such a small problem but it is really not. But, it can be fixed and we took this option first to treat it once and for all. She starts University in a month so we are hoping it will be fixed by then.
Don't worry too much about it. If you have a good surgeon chances are strongly that you'll be just fine.
Just thought I'd update you after seeing the GP. Actually they said its healing very well, most has knitted together already after 2 weeks and there is a slight opening between the last two stitches where the fluid drained but this is now healing also! So aside from the fact it was pretty painful driving there and back (she was in the passenger seat on a airplane neck cushion backwards) she's not on painkillers during the day so I guess I was overreacting and it is going well. The fluid issue is apparently very common and my GP was very pleased with it saying how much better it is than the open excursions she sees. So I hope this is a little reassuring. All the best!
Just wanted to let anyone who's having the karydakis know that mine went really well, I've lost half my ass crack to it but I'm pilo free and have been since June last year.

I had a mini cleft lift which didn't work and my new surgeon suggested the karydakis which has worked wonders.

I hope everyone is healing nicely :)

A little bit of my wound took longer to heal but they use a plastic stitch when the first incision is so it takes slightly longer to heal (an extra 4 weeks roughly but you can sit/swim/etc)
Just wanted to let anyone who's having the karydakis know that mine went really well, I've lost half my ass crack to it but I'm pilo free and have been since June last year.

I had a mini cleft lift which didn't work and my new surgeon suggested the karydakis which has worked wonders.

I hope everyone is healing nicely :)

A little bit of my wound took longer to heal but they use a plastic stitch when the first incision is so it takes slightly longer to heal (an extra 4 weeks roughly but you can sit/swim/etc)
When did you start sitting on it and driving comfortably? I'm 16 days post op and sitting on it for short periods. I'm still leaking but wound looks to be healing ok.
Hi there,

I'm on the fence about future surgery after an incision and drainage for a pilonidal abcess 3 days ago. It had been bothering me for 2 weeks! It did not leak or rupture at all, even when I took hot baths and used castor oil. It was just very red and angry, which led me to believe I have no sinus opening back there...

The procedure was done under general, and the doctor informed me afterwards that there was no evidence of a sinus, just an abcess which they cleared out...and that if I took my antibiotics and went through with the daily dressing changes, it would heal from the bottom up and I would have no further problems.

I'm SO sceptical because I know I&D does not 'cure' pilos...but the fact that I do not have a sinus present, does this mean it is unlikely that the pilo will return if I continue with laser to remove hair there? Or will I need e.g. a cleft lift to prevent it for sure ??

I'm so confused :/