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How the Lap-Band actually works, fills and refills

  • Popular Post

This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN 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 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. That is why the ALLERGAN 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.

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Featured Replies

Hi Wendall,

The thread you have posted does explain a lot of things about the Lap band that I was a little unsure about and now is much clearer.

I had my surgery in July 2007, and I lost 4.5 kgs over the following 5 weeks, I then hit a plateau and remained static. I then had my first fill of 4cc in early Sept but still didn't lose any more weight even though I appeared to be eating much less. I had my second fill of 2.7cc mid October and am still static. What I cant get my head round is that if I am eating less than I ever have and assuming it is because of the fills, why am I not losing any more weight?

Any advice would be appreciated

Jeannie

Hello Jeannie,

I see that you posted this quite a while ago. Have you had any luck since you posted this? I had this very problem while on weight watchers. I would be eating SO much less then I normally did and was actually gaining weight. I stuck it out for months and months and it didn't improve. I am getting a band in 2 months. I makes me worry when I see your post and would like to know that eventually IT DOES come off!

Thanks :thumbup:

  • 4 weeks later...
  • 3 weeks later...
  • 1 month later...

Hi,

Can someone help me, I had surgery 4 days ago and My BMI was 31, I was wondering If I loose 50 lb without fill, do I still need a fill? even with 30 lb I will be happy. I already lost my appetite and I am on liquid for two weeks and then Puree for two more weeks. Does restriction needed for first two weeks?

Thanks any one reply to me.

Being that you only had the surgery a few days ago, chances are that you are still swollen and this causes you to not be hungry and feel restricted. Drs usually want to wait 4- 6 weeks before giving someone their first fill to allow for complete healing. Everyone is different. You will have to wait until the swelling goes down to see if you need fill. I have heard of people who have never needed a fill to get restriction and did really well with an unfilled band. There are also people who need many fills before the band helps them with appetite and weight lose.And then, sadly, there are some who are never able to get restriction. After fills and unfills, I now know exactly how much fill in my band I can handle and that has helped me live happily with my band and be successful with my weight loss. Did you have a lot of health issues associated with your weight in order to have a Dr give you the band with only 30-50 lbs to lose?

I know that my Dr would not perform the surgery unless it was warranted. Best of luck to you! Remember, everyone's band journey is different and there is no answer to your question. You will have to wait and see what you need to be successful.

Edited by Barb12590

Thank you so much? I am diebetic type 2, Insurance did not cover so I paid out of pocket. I will wait to see how I feel

I truly thank you for your respond,

Nooshin

Hi,

Can someone help me, I had surgery 4 days ago and My BMI was 31, I was wondering If I loose 50 lb without fill, do I still need a fill? even with 30 lb I will be happy. I already lost my appetite and I am on liquid for two weeks and then Puree for two more weeks. Does restriction needed for first two weeks?

Thanks any one reply to me.

Don't get a fill if you don't need one. If you feel like you're really hungry all the time, then get one. It's best not to get one unless you need one.

I am nine months out and got my first fill Wednesday. My doc doesn't encourage fills as long as you lose about a pound/week. I had slowed to a .5 pound/week and requested a fill. Listen you to your body. You'll know when you're at your "sweetspot". :glare:

I have had my second fill. This time the PA put the fill in 2 inches below where she put it in on the first fill. I don't feel any restriction yet. Is the change in the location of the port normal? ;) Has this happened to anyone else or do you think she may have missed the port all together the first time?

Can you feel your port? Mine was in a different place after I had lost weight because my skin was stretched out and saggy, but you can usually feel the port.

I was banded April 7th and will see my surgeon May 22nd. I'm anxiously awaiting because i don't have the "full feeling" very long anymore. I guess the healing is taking place and the swelling going down. I don't have the panicy hungry feeling but i do worry about not feeling full & and the ability to fill my bottomless pit of a stomach!

This may help you in understanding the restrictive mechanism of a Lap-Band.

The ALLERGAN 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 4 weeks. A “Delayed-Action” means that the fill may not become effective for up to 4 weeks after the fill. That is why the ALLERGAN 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 for the needed information. I just sent off an email to the nurses to make sure I'm feeling what most banders feel after two weeks post op. I'm having my first fill on the 28th so that's 4 weeks post of and I'm ready cause I feel like I can eat more, but afraid of any restriction. sounds like there is now so want to get back to loosing some weight.

When you do feel the restrictions, is it tightness in the throat?

Thanks for any info and souunds like you are doing great!ha

I don't think you should feel anything in your throat.

When you have restriction you should feel full after eating a small amount of food.

That's the reason for chewing well and eating slowly.

It gives your body time to send those "full feeling" signals to your brain.

I've found if I don't chew well and eat quickly I'm usually very uncomfortable afterward because I feel stuffed. :laugh:

Not to mention the food doesn't go down very well!

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