The time for the rubber band to come off after a high hanging fistula is usually about half a month. Some people may have a shorter time for the rubber band to come off because the position is low and there are fewer muscles hanging, and it may come off in 10-12 days. For some people, it may take longer, even up to about 20 days, because of the high position and the large number of hanging muscles. There are also a very small number of people who are not able to shed on their own and need a second post-operative tightening thread to tie the rubber band tightly, which acts as an elastic cut. There are also some people who are not able to fall off by themselves and need to be cut by the surgeon with scissors before they can fall off. Therefore, the time it takes for a high complex anal fistula to fall off after surgery is usually half a month, but it varies slightly depending on the extent of the lesion, the location, and the amount of muscle cut in each person.