Can anyone shed light on the difference between the two sleeve sizes? Is 32 better because it's smaller and will be more restrictive longer? Or is the restriction negligible? Is the 34 THAT much safer?

Apparently there is not much of a difference at all. In the "olden" days they used to use 42fr bougie or larger, now I think a 34-38 is considered the norm...in Australia anyway. There was some talk a while ago (years) that the larger bougies were safer, but very little of that around now. Some doctors use a larger bougie and then oversew, which makes it marginally smaller, but seriously there is not a hell of a lot of difference. There is a picture doing the rounds on the web of textas and pens lined up, representing bougie sizes and its a little hard to tell the difference between them.

I haven't seen the picture of the bougies (Google, here I come), but that's 32 millimeters versus 34 millimeters. That's about the size of a set of quotation marks. " I doubt that is going to make a huge difference in the amount of restriction we feel. I think mine is a 34, but it's been so long since I asked my surgeon that question that I don't remember for sure. I know I am still only capable of eating about a cup of food, and that's when it's chewed well and eaten slowly. What actually turns out to make more of a difference in capacity is how LONG your stomach is apparently. Usually taller people have a longer sleeve and that may give them an extra 1/3 of a cup of capacity versus shorter people. That's still not much food and we're supposed to under-eat our sleeve anyway.

Dr Alvarez has some videos on Youtube that address this you should check them out!

The difference between a 32 and a 34 is almost certainly not going to make any difference in your long-term success.

If you pick a surgeon that you trust and that has good stats, trust that whatever size bougie he or she uses is the size that works best in his or her experience. There are other variables that go into what the ultimate size of your sleeve will be - like if the surgeon "overstiches" or not... and maybe even more significantly, what the length of your natural stomach is (along the lesser curvature).

A 32 or 34... or even a 36 or 42... will give you good restriction and you will lose weight! It's great that you are thinking about these things, though, and researching them. Lots of research seems to be the mark of a successful sleever!

Capacity wise - not much difference. In terms of success stats (loss) - virtually no difference.

The main difference is in stricture rates. 32 has a significantly higher risk (I'm forgetting the exact number, but it's noticeably higher) than the 34. My surgeon won't even do a 32 (lots of patients come in requesting it) because of the stricture risk. He does most at 34, sometimes larger.

It's really just a guideline, though. The chance of two stomachs cut on a 32 having the exact same capacity in, say, ccs -- probably not even measurable.

Capacity wise - not much difference. In terms of success stats (loss) - virtually no difference.

The main difference is in stricture rates. 32 has a significantly higher risk (I'm forgetting the exact number, but it's noticeably higher) than the 34. My surgeon won't even do a 32 (lots of patients come in requesting it) because of the stricture risk. He does most at 34, sometimes larger.

It's really just a guideline, though. The chance of two stomachs cut on a 32 having the exact same capacity in, say, ccs -- probably not even measurable.

What is a stricture risk?

What is a stricture risk?

Short and sweet - your risk of developing a stricture. Leaks and stricture are our two most common complications. A stricture is when the opening from the stomach to the pylorus closes/narrows due to growth of scar tissue. Your stomach basically developes a clogged pipe and you aren't able to get anything through, and it backs up on you. Resolved by dialating the structure.

Strictures are about half as common as leaks, if that much.