Thanks again to Wendell for posting this elsewhere. It deserves its own thread. Great information to educate us...

This may help you in understanding the restrictive mechanism of a Lap-Band. The INAMED protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band. Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

Thanks again to Wendell for posting this elsewhere. It deserves its own thread. Great information to educate us...

This may help you in understanding the restrictive mechanism of a Lap-Band. The INAMED protocol for Lap-Band fills calls for a six-week delay after surgery, prior to any fills. The purpose for the six-week delay is for the patient’s stomach to heal from the surgery, as well as allowing time for the Lap-Band to “Seat” or “Nestle” into the fat pad between the stomach wall and the interior wall of the Lap-Band. Prior to receiving an EFFECTIVE fill, it is VERY uncommon to have any restriction from a Lap-Band. Some patients will NOT lose weight, or may even GAIN weight until they have received an effective fill in their Lap-Band. Normal weight loss with a properly restricted Lap-Band is between 1 and 2 pounds per week.

The normal cycle of fills, restriction and weight loss is as follows:

1. The patient's Lap-Band constricts when the patient receives a fill. Swelling for a few days after receiving a fill is very common. Many doctors require a patient to go on a liquid diet for a day or two after receiving a fill. A fill may have a “Delayed Action” of up to two weeks. A “Delayed-Action” means that the fill may not become effective for up to two weeks after the fill. That is why the INAMED protocol states that fills should not be performed on patients who will not have access to medical care for at least two weeks after a fill.

2. The patient's stomach capacity is lessened as a result of the restriction caused by the Lap-Band.

3. The patient loses weight because they cannot eat as much food.

4. The residual fat-pad between the inside of the Lap-Band and the outside of the patient's stomach reduces in size because of the overall weight loss in the patient.

5. The reduction of the residual fat-pad causes the Lap-Band to become loose again.

6. At that point, the patient needs another fill, because the Lap-Band is loose, and the patient has a loss of restriction, which allows the patient to eat larger amounts of food.

7. The patient receives another fill and the process starts all over again.

Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill.

Thank you for the compliment!

thanks for the info! good reading!

so how do you know or monitor the fat pad? I am probably on my 8th or 9th fill, lost count honestly. Been banded little over 6 months now and still never really have restriction. I have maybe a week or so at a time but that's about it. Any thoughts?

Don't get me wrong. I am very pleased with my progress. I am just wondering when I get towards the end of that and the fat pad is gone? Is there a % of body weight loss or something as a guide? I am sure it is different for everyone but how do you gage it?

so how do you know or monitor the fat pad? I am probably on my 8th or 9th fill, lost count honestly. Been banded little over 6 months now and still never really have restriction. I have maybe a week or so at a time but that's about it. Any thoughts?

Don't get me wrong. I am very pleased with my progress. I am just wondering when I get towards the end of that and the fat pad is gone? Is there a % of body weight loss or something as a guide? I am sure it is different for everyone but how do you gage it?

That is a very good question.

All my fils have been done on a fluoroscope, so it's easy to visually confirm the opening of the stoma. That shows the tightness of the fill, which would seem to indicate the reduction of the fat-pad. I didn't obtain effective restriction untill my 4th fill, and have had to have more fills after that to compensate for the reduction of the residual fat-pad.

After my 7th fill, it was a VERY long time until fill 8, over 14 months, with effective restriction that whole time.

So in my experience, I know that the residual fat-pad was going away based on the time between fills and the very tiny amount of fill required to re-obtain effective restriction.

Ok so my band holds 10ccs, I just had my 2nd fill and my band has 6 ccs in it. In the next 2 fills I will get 1 cc each for a total of 8 ccs, all they have left is 2 more ccs and my band will be filled to capacity. What is going to happen as I loose weight? they can't fill it more than 10 ccs!

Very good info!!!!!!!! Thanks again Wendell...what would he do without you?? You are a wealth of knowledge, information, and inspiration

Ok so my band holds 10ccs, I just had my 2nd fill and my band has 6 ccs in it. In the next 2 fills I will get 1 cc each for a total of 8 ccs, all they have left is 2 more ccs and my band will be filled to capacity. What is going to happen as I loose weight? they can't fill it more than 10 ccs!

I had the same question...so I re-read the post after reading your question...here's the answer...at least I hope it answers your question

"Most Lap-Band patients receive several fills to adjust the Lap-Band as their weight loss progresses, and there is less and less residual fat-pad between the inside of the Lap-Band and the exterior of the stomach wall. Once a patient has lost all of their residual fat-pad, fills become less common. As the Lap-Band patient progresses in their weight loss, the effect of very tiny fills (Less than .2ccs) becomes greater and greater. It is not uncommon for a late-stage Lap-Band patient to experience a significant difference in restriction with as little as .05cc of fill."

Ooooohh! Thank you very much for explaining this.