Search the Community

Hello Everyone! I now 53, I had revision done from lapband to gastric bypass 12.10.18. Thus far I have lost 100 lbs. Sad to say i wish it would stop. Lol. No major complication, now I am dealing with a lot of snagging skin, butt look like elephant legs, breast look like IV bags and arms look like a turkey neck.🙄. Health wise I feel pretty good. Wishing everyone the best of luck, please, please follow your doctor instructions.

I’m 51 and having revision from band to rny November 26th.

It is difficult to compare the two directly as few surgeons do both, (Mitchell Roslin in NYC is the main one I can think of that actively performs both) so there a lot of variables that get in the way. The DS is indeed the most powerful procedure commonly available, but it is also the most complicated to do, which is why few surgeons offer it. It has been around since the late '80's, it is one of the procedures endorsed by the ASMBS (along with the VSG, RNY and bands) and accepted by US insurance as a mainstream WLS procedure (they can't call it "investigational" any more since Medicare started paying for it.,) The SIPS (SADI, Loop DS, and other names that it goes by,) is newer and not as well established, nor quite as standardized, as everyone is still figuring out the optimum configuration. It is being promoted as being "almost as good as" the traditional DS, but "more accessible" - simpler so more surgeons can offer it. The hope is that it will fall somewhere between the RNY and DS in performance, with fewer side effects and limitations than either. If that holds true, then it will earn a spot in the WLS world, and if not, it will be another procedure that doesn't quite make it, like the "mini" bypass. Most of the BPD/DS surgeons don't offer the SIPS as they don't need a simpler procedure, and already have the VSG for the less challenging patients. Here is one very biased opinion on it from one of those surgeons: https://www.dssurgery.com/weight-loss-surgery/sadi-sips/ The position of the ASMBS on the matter: https://asmbs.org/resources/position-statement-single-anastomosis-duodenal-switch and, here is Dr. Roslin's take on it: https://www.nycbariatrics.com/weight-loss-surgery-options/sips-procedure Dr. Roslin is well quaiified on the BPD/DS (and is one of the few with the skills to do the very complex RNY/DS revision) but it seems that he is actively working on the SIPS for the greater good of the WLS community as a whole - that "almost as good as, but more accessible" concept that can hopefully benefit more patients over the long run. At this point, only time will tell. As an individual decision for right now, that's a tough one. With your regain history, I would be inclined to go the the well established BPD?DS, as that has proven to have the best regain resistance, but that would likely involve travelling for you (I don't know of any DS docs in MA, but there are several in the NY/NJ/PA area.) It is good to see that you are doing the "head work" as that is an essential part of any of these procedures - one can "eat around" any of them, though it is harder to do with the DS. One of the things that I have found to be helpful is what this doc covered here - One of the things that doesn't get covered much by other surgeons is that our eating capacity does increase slowly over time, and this is something we have to compensate for. One may or may not get along with this doc's prescription for a veg first diet, but it does make sense from the perspective of filling in that added capacity with bulky, low calorie veg. Think about it, discuss it with your therapist, and maybe you find a different approach to handling this problem. Good luck!

Sure! I love talking about this stuff with people I know won't judge me. My friends all look at me like I'm crazy... Anyway, I know if I have my band removed my weight will explode. So the surgeon I'm seeing says I could have a revision done in one surgery--right after removing the band he could do a sleeve or an RNY. He said the sleeve was a bit more difficult to do because of the scar tissue the lap band will leave behind after the removal, but could be done. But the main reason I'm going with the RNY is I used to have terrible acid reflux before I got my band. The band all but cured it. And many people who have never even had trouble with reflux develop it after getting a sleeve so that sounded too risky. And I've developed a touch of maturity onset diabetes, and a RNY is supposed to really help with that. So that's why the RNY. If you need to know more, just ask! WLS isn't for the faint of heart and it's great to find like-minded individuals to discuss this with.😁

With the fact that you have gerd the dr should be able to get approval for the revision I have only had the Vsg and preparing to revise to bypass. Gerd is my issue as well.

JRT Mom: I'm unfamiliar with all the newer procedures and/or revisions. Did study the RNY prior to my own Band. Wondering if you would mind informing what makes that your choice now? Thank you, Jack '04 Bandster

I’m researching SIPS vs DS and I’m so confused on the correct choice! SIPS seems easier to live with less side effects possibly and an up and coming surgery while DS has been around longer and has more follow up data. My surgeons office only does SIPS and truly has not done that many of them so I’ll probably switch surgeons as well. My story is that I had a nightmare band experience in 2011, didn’t lose much at all and regained all as well as port discomfort etc until being revised in 2017 to sleeve. I did amazing on sleeve for 2 years lost almost all my weight (112lbs) but regained about half. I’m desperate to find the right surgery and so afraid I will make another mistake! I know I need a more powerful surgery than the sleeve and yes I’m doing the “head work” in therapy. Any advise on which I should choose or how I should make the decision?

I'm looking at a revision from sleeve to DS loop too. How are things going now? Also, you mentioned you were self pay - do you mind sharing the cost? I'm looking into insurance but might end up being self pay too. Thanks and I hope you are doing great!

no problem Mac..... Have you been approved Yet? Reason i'm asking..... most insurance requires 35 BMI with 2 co morbids. When i had my band in 2009 it was the requirement. ORRR 40 BMI which is where i was. 5'2" and 232lbs. This time i didn't have to because i was still considered a revision even though my band was removed 2.5+ years ago. My bmi this time was 31. SW 173.5..... Today, 145.2 Fk yes.... Back to you.... if you have not be approved yet, you may want to lay off the dieting. Some insurance with not approve you if they see a weight loss. My dr. advised me to not lose anything till i got the final approval. Did you go watch the youtube vids...??? I've been in the WLS community for over 10 years and he is 100% right with everything he says..... no sugar coating with him at all.

After many months of jumping through insurance hoops I’m scheduled for November 26th for my revision from lap band (2008) to rny. And the new journey begins!

I've not had a revised sleeve, but I revised from lap band to sleeve. Full disclosure, I went several years in between surgeries. BUT, I can say with experience that the weight loss was (and continues to be) slower to come off the 2nd time around. Another case in point: a friend of mine who also converted from lap band to sleeve lost a total of 6 pounds in her first 2 months! Be patient. Stay the course and it will happen.

Gosh so sorry to be MIA! I continue to be so inspired by each one of you and this thread always brings a smile to my face, no matter how difficult the day may be!!! You all look GORGEOUS!!!! And love the fashion inspiration! Took some pics for a meeting last week. Here's the latest. 20.5mo PO RNY. 130.2lbs Maintenance. My body may have decided to defend a lower set point rather than the 135lbs that I thought it was happy at. I have lost and gained the same 2-5lbs from 130-135lbs for a while now. Just last week I briefly saw 129lbs. Now after a big weekend of fun and frivolity, I came back at only 130.2lbs--which means I may be 2lbs lighter by Friday. I'm not hatin' on that--honestly. I have wanted to reach my super triple top secret BDG Goal since I started this process. But when it didn't look like I would ever hit my 130lbs goal, I kinda released that into the ether and called maintenance at 135lbs revised goal. Then I hit 130lbs and revised the revised goal back to 130lbs. But now it looks as if I might actually make 125lbs (super triple top secret Barbie Dream Girl Goal). I'm pretty thrilled at this weight and I love how I look in clothes these days (or at least I'm moving in that direction). My gigantor turkey thighs are slightly less pronounced now. And I asked Mr. F. if he thought I looked too thin or sickly. He said that I didn't. He's very honest and objective, so I know I can go to him as a touchstone with reality. I bought 3 pairs of size 8 skinny jeans from goodwill this weekend. And I'm actually in between a 6 and an 8--oddly so. The legs fit, but the the little bit of belleh skin doesn't let me fasten them. Wah. Oh well. I saw my plastics dude last Friday. A bit of a buzz kill. He told me my insurance wouldn't cover the saggy droopy booty, even though it was giving me significant issues. He did say that I have very very little excess fat on my body - as he was looking at me totes nekkidy and that he didn't want me to lose any more. Of course I lied and said, "Swearsies! I'm not plannin' on it!" (wink wink nudge nudge saynomore...) He still says that I need to wait on my capular contractures in the reconstructed foobs. But he wants me to consider getting nerp tats so I look more like a real gingerbread girl--and less like a Skipper Doll (Barbie's younger annoying kid sister--anotomically incorrect and lacking a kung fu grip). Still chewing on that one. Don't know what to do with that information yet. Sorry for the book!!!

I had my surgery 10/24 and went back to work 10/31. My surgery was a bit more complicated than anticipated. I was a revision and they didn't think my band had slipped, but it had and it was very difficult for them to remove. I have had some problems with my heart rate shooting really high just from walking a short distance. I feel like it's slowly trying to get better, so I'm just taking that one day at a time. I have another appointment on Wednesday to see if any answers can be found. Other than that, everything has gone great and I'm essentially pain free minus where I had a drain after surgery. I did buy a decent bit of protein powder to have after surgery and now I only like one of the flavors.. I knew that would happen, but it's still a bit of a bummer. 🤣

This is not from my personal experience (I've never had a revision), but I've read the weight loss is a lot slower the second time around.

I had the band in 2010, revision to sleeve in 2014 due to major band slip (couldn’t even drink water with empty band), and now having acid reflux and weight gain following a hysterectomy in 2016 and looking for options to revise again. Anyone else have a similar situation and any success with insurance approval?

I never had a sleeve after the band but was converted to MBG (that was a stretch as well regarding the reflux but there were reasons MGB was chosen over RNY in consent). Talk to a surgeon about revision because of the reflux. Weight loss could be significant but doesn't has to be.

I’m looking Into the same thing now. Band in 2010, sleeve in 2014, and now another revision to ??? Due to acid reflux and weight gain post hysterectomy. Any recommendations regarding the next surgery choice and insurance approval based on your experience?

On my invoice, the procedure is just called BRACHIOPLASTY. The side boob skin removal is not considered part of the arm lift/brachioplasty with my surgeon. It is part of a separate procedure invoiced as BILATERAL BREAST REDUCTION REVISION, which is basically a breast lift with auxiliary breast removal from flanks. My doc is awesome as he is charging me with a revision instead of a first time breast lift (which really is what I am getting but is about 5K less expensive) as I had a breast reduction several years ago, and he is already going to be there doing the arm lift anyway. With that said however, I did speak to another surgeon (who I didn't end up going with) who combined the arm lift and auxiliary breast removal (without breast lift) and he called it BILATERAL ARM LIFT WITH CHEST WALL EXTENSION. He wanted to do it as one continuous incision. Edited to add: Neither my surgeon nor the other fella I mentioned above post patient photos on their websites (I had to go in for appointments to look at their patient results books)

I’m looking into the same thing as the OP. Band in 2010, revision to Sleeve in 2014 due to band slip resulting in the inability to even drink water, and now looking for another option due to acid reflux and regain after a hysterectomy in 2016. I never felt restriction with the sleeve and didn’t lose much after the sleeve and now am half way back to where I started on my WL journey. I’m going to call my WL surgeon to make an appointment to see what my options are at this point and to see what is needed for insurance to pay. If anyone else with a similar experience has any words of wisdom to share that would be greatly appreciated.

Hello! I'm so glad you posted. I will be having my revision VSG to Loop DS surgery with Dr. Medlin next month. How did it go for you? How is everything going now? How was flying? Thanks for any info/tips!

What surgery did you have? I had reflux for many years before I had a revision in Sept. What I did was not eat after 7 pm (this one will depend on when you go to bed) elevate your mattress or prop yourself up on many pillows. Avoid spicey foods and all that jazz. Do call your surgeons office and they may up your Omeprazole dosage. I was taking 40 mg every morning. Hope you feel better soon!

I have 1-2 drinks maybe 3-5 days a week. Some days I have 1 daily. Occasionally I have more like when I went to Vegas. I just make sure I’m not driving because how it hits me is unpredictable and I make sure I use low calorie mixers and include it in my daily macros. I found FitVine and it’s damn good wine for lower carbs and keeps the alcohol content like normal wines. After my sleeve my first drink was about 3 months out (had 1 for thanksgiving). After sleeve revision I waited a couple months. I’ve had a complication that’s either ulcers or something else (getting my cat scanned Thursday). So for now I’ve put away all coffee, alcohol and most caffeine but I’m a slave to Diet Coke so I have one every other day. I’m secretly hoping it’s some easy to fix complication vs ulcers because I desperately need to start using my topical NSAID for a double shoulder repair. No pain meds and I’m suffering!

I needed revision. NEEDED. I make the distinction for anyone who is in my shoes and contemplating revision. I did regain 50 lbs but it was purely because of high dose steroids for 5 months. The journey is different when it’s weight regain revision vs medical revision.

I think this question is not easy to answer in many cases. Reflux is a common reason people are getting bypassed after having been sleeved or banded. Lack of weight loss or weight regain is another. However, I don't know what the most common reason is. Anyway, it's always a question of "What does the patient want and what does the patient want to live with forever and what risks is the patient going to take by having another surgery or by not having another surgery". So decision to get a revision can for sure take its time. I'm still on the fence if I should take the risk of another surgery (hiatoplastic, gastropexia, maybe even changing the anastomosis, depending on what they see during surgery) or if I should live with it the way it is and get control gastroscopies yearly. Since there is no guarantee that everything will be fine and dandy after another surgery, I'm very hesitant and regardless of what I will choose in the end, I won't rush it (luckily there doesn't seem to be a need to) and nothing will happen before January or February anyway regarding another surgery. I simply need time to come to terms with all of this. "The process of a revision". I'm not sure what you mean here. Insurance issues? If so, it seems to depend on insurance and the reason for revision if that is a major hurdle or not. I can't contribute anything useful to this since insurance system in Germany is quite different from that e. g. in the US. However, everything revision starts with a visit at the surgeon's office and then you go from there.

Very interesting how the sleeve is gaining momentum. Also interesting that as the band % goes down, the revision rate goes up. The band just didn't measure up over time. I wonder what the actual revisions are: band to RNY, sleeve to RNY, Band to sleeve?