Surgery, Xiaflex, or needle?

I have done radio therapy with no luck. Now I’m afraid it’s time for another intervention. The growth is moving past my middle knuckle on the pinky and is getting in the way and painful.

I’m not sure if I should go straight for surgery, as my dr said surgery can exacerbate the issue by instigating it to grow more aggressively. But xiaflex and needle aponeurotomy don’t actually remove anything so the issue rebuilds faster.

Which procedure would you consider first?

I have it affecting both hands in multiple places, but my pink is the only one causing me issues right now.