I had a LA before the epi with #1(and forceps) it was a very big cut and required stitches inside and out (looking back now maybe I tore as well?) The doctor cut badly inwards towards the back and my OB commented unfavourably on the scar while I was having Riley last year (nearly 15 years afterwards!) I went on to have 2 more babies with no tears or epis so it must have healed well at least.