Brief Answer: You have the right to request for removal Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear of these disturbing thought you have with the way your anal area looks like. I have taken a look at the attached image. For real, there is no physical pathology for surgery to be carried out on this area. But if it is what you want for yourself, it is your right to request for. Just like persons request for plastic surgeries on their faces without any medical reasons, you also have the right to request for this. It is true that it is really rare because this area is often hidden in our under wears and people are rarely concerned about how it looks. Given your sexual orientation, I understand how important this is to you. There are doctors who would deny this categorically because they think the problem is more of a mental disorder than a physical disorder. I think this is where your doctor falls. He was more comfortable operating upon for the fistula because it was a physical problem and the benefits were clearly evident to him. In any case, if your are not mentally satisfied with it, you cannot be considered as being well. So this needs to be addressed to offer a complete state of good health to you. I understand how much you want this removed, however you would need to go through some mental preparation to make sure you understand the exact risks of the surgery and what the advantages of no surgery are. Also, if you can come to terms with it and stay happy just the way it is, it would make great sense rather than going through all the pains that this requires. If this medical aspect should fail, then you would proceed to removal. The best doctor would have been a colorectal surgeon/proctologist. If you cannot find one, then consider getting a plastic surgeon who can help do this. Assuredly, it would be difficult to find doctor to do this because of the absence of a physical disease but, it is not impossible. Dermatologist and primary care doctors would be unable to address this condition. I hope this addresses your query fully. Thank you so much for patronizing our services and please do feel free to ask for follow up clarifications and information if need be. I wish you the best of health. Dr. Ditah, MD.

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Brief Answer: Thanks for this follow up! Detailed Answer: Hi and thank you some much for this follow up prescision. I am not surprised that many doctors do not want to do anoplasty. This si clearly something that has rarely been done before and am sure none of your doctors has ever attempted this on the grounds of aesthetics. As I mentioned to you, this is going to be a very difficult task to find a doctor that can do this and also accept to do it. It is entirely your right to ask for this procedure and the doctor's right to accept doing it or not. This makes it a lot more difficult. I will suggest that you patiently continue seeking but, the chances would be extremely low to come by. Unfortunately, I have never had a client who has requested for this or had it done. I do not also know of any doctor in your area who does this. I hope I have answered your questions though unable to provide that magic referral that you need dearly now. I wish you the best as you continue the search. Dr. Ditah, MD.

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