I had an epi with DD1 but not by choice, they needed to get her out because her HR dropped which at the time i didnt know it does anyway when coming out the birth canal. I think the ob just wanted to go back to his dinner date.
I just had slight grazing with DS2 so it didnt interfer with following labours. I did find it quiet painful and it took a while to heal, but daily salt baths eased the pain alot so id suggest that if you need one.
With DS the midwife mentioned its better to tear naturaly rather than get cut because the tear would heal more normally, the skin goes back together like a jigsaw iykwim where as with sutures your skin is put not necessarily in the same position. If that makes sense.
I would never opt to be cut, but thats just me. Ive already had it and wish i could go back and do it again to say no way mate.