This is a Core Lecture. It is a fully narrated stop motion photography presentation allowing me to point out specific anatomy and corresponding surgical techniques. The video is not as clear optically as I would like but is sufficient to get the key steps fully covered and explained. The markings are described fully, the RF incisions are performed with attention to detail, the A Incisions are fully pointed out, and the layered suturing technique is shown. At the end of the video the large External Anal Skin Tag is excised with pearls discussed on how to avoid complications. Post of photos show the progression of healing with time.