I’d actually go for the Tonsil Regeneration for the surgery. With the tumorous kidney alone, there’s no way a level-capped troll is going to use up all of their dbaggery before they finish a forum, and every point of ego that you can afford to respec into offense helps.

edit: I should probably post my items/stats, actually:

2051 ego

610 dbaggery

149 offense

143 defense

fetish: Tumorous Kidney

glbumes: Versnatche Earbleeders

doc file: Notorious B.I.G. (don’t have an INCIT yet, not sure if I’d use it if I did – +145 ego might actually be worth -1 offense, and defense buffs are more or less negligible at this point)

music file: Pink Floyd

pic file: Pictures of YOU (very slightly better than Soggiest Cracker, don’t have blood spatter art yet)

program file: Useless Program

special item: Complete Set of Dragonballs

surgery: Tonsil Regen

video: Step by Step Yoga (I’ve got ****.Milf, but I’ll take the -2 offense/defense in exchange for the +105 ego)

At this point, I’m pwning the level 35 forums with 2-3 shots/thread tops. Could probably afford to lose another 3-500 ego, but I’d like to run ESF a few more times to make sure.