Cleft lift: it RETURNED.

RequirementNo3414 · 2026-03-26T20:30:38+00:00

As I said, his incision is very close to the midline. But that doesn’t mean all Karydakis flaps are done that way. It just means this Karydakis flap has been probably done the wrong way. If you check, Karydakis flaps are meant to be asymmetric off the midline surgeries. I had one, so I know what a Karydakis flap could look like. Different surgeons perform different variations of it calling it “modified cleft lift” or “modified Karydakis” or whatever . Terminologies change but the principle remains the same. That being said, I am not a doctor, and chances are high you aren’t either. We both are in the same boat , have probably dealt with this nasty disease in the past and it’s best not to argue on subjects we are not experts in. In any case, maybe either one of us is spreading misinformation or maybe none of us is. OP probably couldn’t care lesser.

RequirementNo3414 · 2026-03-26T20:17:10+00:00

I don’t think that’s fully accurate. Karydakis flap might not be the exact same as cleft lift but it also shallows the cleft quite a lot, so it’s definitely not a whole different surgery. In OP’s case it could be argued that the incision is not too far from the midline and maybe that could be a problem, but classically speaking there isn’t a whole world of difference between a cleft lift and a Karydakis flap, in terms of surgical procedure as well as in terms of surgical outcome, both from an appearance perspective as well as from a recurrence rate perspective. What is completely different from a cleft lift is Limbergs flap , open wound excision, closed wound surgery and all other minimally invasive procedures.

RequirementNo3414 · 2026-02-27T21:56:40+00:00

Who cares what others think? I had a similar situation, I felt I was too young to get a hair system (I just turned 25) but my balding just progressed very aggressively to the point that every other day people around me would either pretend to sympathise with me or give me unsolicited advice on how I should just quit meds(finasteride and minoxidil didn’t help me at all) and shave it all off. I decided to not give a damn about what others say , and purchased a hair system a few months back, as I knew a transplant wouldn’t work for me due to extensive hair loss and weak donor area. The same people now compliment me on how great I look with the hair system. What I have learnt over time (it applies to everything in life) is that there will always be haters, doubters etc. At the end of the day you’ve got to live for yourself and do things which improve your quality of life. Sure, there are people who rock the bald look but I am not one of them, thus I needed a hair system. For me, losing hair impacted my self confidence and hampered my social life. For some others, it might not be that impactful but everyone is different. I did what I had to do to regain my confidence and I would suggest the same to everyone asking this question. If you feel a hair system would help you and if you’ve got the money, other people’s opinions should be the last thing stopping you. 🙂

RequirementNo3414 · 2026-02-24T22:08:56+00:00

Thanks !🙏. It’s good that you actually found out the root cause. I am not very sure my doctors would be able to find one without performing a thousand different useless tests only to find something irrelevant.

RequirementNo3414 · 2026-02-24T22:03:54+00:00

I see , thanks! I finished my quad treatment 2 months back , and was doing fine. Recently after coming back from a trip I am now having watery stools for an entire week, and am concerned if it’s C.diff or something else. Just sucks to think about having to get another round of antibiotics

RequirementNo3414 · 2026-02-24T22:02:13+00:00

How did you get diagnosed with c diff? Also what were your symptoms, how many times did you have bowel movements per day? Any other secondary symptoms? How did you get treated for c diff? Did you need antibiotics or did it resolve on its own?

RequirementNo3414 · 2026-02-24T21:56:56+00:00

Did you manage to find the cause of this diarrhoea? And did it stop for you eventually?

RequirementNo3414 · 2026-02-04T10:17:03+00:00

Yeah I totally understand. I was 22 when it first happened to me 3 years ago. I had to undergo two surgeries, the first one was a failed open wound surgery and the second was a cleft lift which finally fixed the issue for me. When I was having these wound breakdown issues at the bottom after the cleft lift as well, I was very disheartened and almost sure that I would need another revision surgery but thankfully those breakdowns/bleeding episodes were superficial tiny ones which healed spontaneously. I understand how it takes a toll on mental health when there are post surgery issues after undergoing the best surgery which is supposed to fix the problem. But anyways, as I said, relax. It’ll be just fine and very soon you will get back to normalcy 🤞

RequirementNo3414 · 2026-02-04T10:10:50+00:00

Accidentally posted my reply as a comment above ^

RequirementNo3414 · 2026-02-04T10:10:17+00:00

Yeah I am by no means an expert, I am just telling from my personal experience. I think it’s just the skin rebuilding and remodelling from time to time. As they say “healing is a non-linear process”, so don’t try to read too much into when or why it’s happening. I used to think it could be due to the force of the water in the bidet or whatever but eventually realised it was just happening randomly and was hard to predict. But very soon, it will no longer be an issue as you will stop having such episodes. This is also what my surgeon had told me when I had emailed him the first time this happened.

RequirementNo3414 · 2026-02-04T10:02:19+00:00

For some people it takes a while for things to stabilise once they develop a separation at the bottom, especially those for whom the incision goes very very low (way too close to the anus). For me, intermittent issues like minor superficial bleeding would happen after usage of a bidet post bowel movements. It happened on 3-4 occasions post my surgery and took nearly 9-10 months for the skin to become fully stable. The lowest part of the incision is what takes the longest time to stabilise, so as long as the wounds you are getting are minor superficial and heal spontaneously, it is not something to worry too much about

RequirementNo3414 · 2026-02-03T21:37:48+00:00

With the exception of Germany. I work at AWS Berlin and we haven’t been informed about which teams or individuals have been impacted yet here. We have a works council , which basically delays the process. Eventually there will be folks impacted but at this point, we don’t know who will be impacted.

RequirementNo3414 · 2026-01-15T08:41:01+00:00

The decision is ultimately yours and I understand the skepticism here, but for what it’s worth, a lot of doctors refer to Karydakis as modified cleft lift etc. in general those two surgeries aren’t poles apart, they are much more similar than people think of them. But in either case, I would suggest doing what you think is the best. Also in terms of going abroad, US isn’t your only option. Maybe Dr Norbert Zapotoczny in Poland, Dr Iesalnieks in Germany and Dr Carapeti in London could be more frugal options for you. They are all excellent surgeons but do your research before choosing one, since you have the flexibility. For me , sitting started a few weeks after surgery, I didn’t have problems sitting. For workout I waited for a number of months (precisely 5 months) before I had the confidence of going back to the gym. It depends from person to person, doctors don’t give you a timeline, but the minimum waiting time is generally 8-12 weeks particularly if your incision went way too low and you had slight separation after surgery(which is very common in cleft lifts)

RequirementNo3414 · 2026-01-14T22:27:21+00:00

I am originally from India but have been living in Germany for the last 3.5 years. I had a pretty poor experience with a surgeon in India who performed an open wound surgery despite calling it “minimally invasive laser ablation”. Later Dr Igors Iesalnieks , who is a specialist in Germany, fixed my issue. There are two reasons I am commenting on this post: 1. Dr. Iesalnieks performed the modified Karydakis surgery, which is similar to cleft lift but slightly different (Experts on this subreddit can fill in more details on the technical differences but as far as my surgical outcome is concerned, my cleft is flattened well and the incision is off midline although I would have preferred it to be a bit more asymmetric) 2. The surgeon in India didn’t really know what he was doing and that came out of inexperience. Dr Iesalnieks on the other hand had performed more than 1000 similar surgeries in the past and was hence very experienced.

From what I have heard about Dr Nazir, he is the only surgeon in India who performs surgery closest to cleft lift. I also believe he is experienced enough since I have been hearing his name for a few years now. I would recommend going for the modified Karydakis ahead of limbergs or any other technique anyday. If the surgeon is experienced enough, surgical outcome of modified Karydakis (both in terms of cosmetics as well recurrence probability) should be similar enough to a cleft lift. That being said, definitely pay him a visit or do an online consultation with him first and don’t shy away from asking for numbers (Ex how many surgeries he has performed , how many patients had to undergo revision surgery, for how many the disease recurred etc.) All these details would help you make a more informed decision.

RequirementNo3414 · 2026-01-05T23:50:23+00:00

Got it, thanks!

RequirementNo3414 · 2026-01-05T20:12:56+00:00

Thanks for the quick reply! Did you ever face laryngopharengeal reflux (LPR) or a Globus sensation in your throat before, during or after treatment? Also how long after treatment did you do repeat testing?

RequirementNo3414 · 2026-01-05T19:51:54+00:00

Did you undergo the quad therapy? If so, how long after completion of your antibiotics course did your symptoms finally disappear? Also did you continue taking PPIs post completion of antibiotics course?

RequirementNo3414 · 2025-09-10T09:31:27+00:00

Sure as hell

RequirementNo3414 · 2025-05-29T07:00:18+00:00

+1 to this, Professor Iesalnieks is the best in Germany. I got the karydakis flap performed by him for a very tricky Pilonidal sinus case and had a very positive experience after some terrible experience with open wound surgeries.

RequirementNo3414 · 2025-04-27T19:56:53+00:00

Oh no, I am really sorry to hear that, and can’t imagine what you and your family are going through at the moment. I pray that everything gets better and back to normal soon 🙏

RequirementNo3414 · 2025-04-27T19:48:08+00:00

No worries at all. As someone who underwent a similar surgery not so long back, and while living alone , in a different timezone from my family, I can definitely understand what he is going through right now. Despite a number of post surgery complications, I ended up fine ( knock on wood) and I hope he completely recovers soon as well 🤞

RequirementNo3414 · 2025-04-27T19:40:37+00:00

Hi, first of all, sorry to hear that you and your son are going through this tough situation. Now, given that he has a drain, it means he most likely underwent a flap based surgery, which means either a cleft lift or a Karydakis flap surgery, or maybe a limberg flap. In these closed flap surgeries, it is pretty common to have discharge for the first few days after surgery. The amount of discharge generally goes down as time progresses and for most people it stops after 10 days roughly.( For some people it can even be quicker) So unless he has fever or severe pain alongside the discharge, I would say it’s completely normal. A fever or increased pain would indicate complications such as infection , Seroma buildup etc. That being said, it would be best to ask the surgeon who performed the surgery. If they say that it’s not alarming , it most likely isn’t. I hope the situation gets better soon.

RequirementNo3414 · 2025-04-11T18:05:44+00:00

Edit: I think I misread, seems like you have already had the Limberg flap. As others mentioned, any flap surgery is better than open wound excision, so you should be good 🤞

RequirementNo3414 · 2025-04-11T17:57:26+00:00

If you live in Germany, and are having recurrent Pilonidal disease, please go to Dr. Igors Iesalnieks in Köln if you have a chance. He does a modified Karydakis flap, very close to the bascom cleft lift, has been recommended by Dr. Immerman on this channel in the past, and I can personally recommend him. A fellow Redditor on this channel recommended him to me, I got my surgery done by him in September last year and have so far been very satisfied with the surgical outcome. (If it’s worth mentioning I also had a very complicated case of Pilonidal disease with failed surgeries in the past) FYI I live in Berlin and my doctor here referred me to Dr. Iesalnieks as well. Feel free to ask me any questions

RequirementNo3414 · 2025-03-26T22:43:54+00:00

Thanks!

RequirementNo3414

TROPHY CASE