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.

I love this thread thanks to whomever bumped it!

I've had 4 fills and had been holding my sweet spot since AUGUST............. HOWEVER I am noticing that I am eating more now.... so looks like fill number 5 is in my future.

I too had a 3 cc first fill with the VG band. My fill nurse said they are learning to be more aggressive with the larger band, but 3 cc didn't do it for me. I've had two more fills. Now at 6.2 cc. I can definitely feel restriction (for the first time), but I'm still able to eat a normal size meal if I chew well. The VG band definitely requires fine tuning. I keep reminding myself to be patient.

I too had a 3 cc first fill with the VG band. My fill nurse said they are learning to be more aggressive with the larger band, but 3 cc didn't do it for me. I've had two more fills. Now at 6.2 cc. I can definitely feel restriction (for the first time), but I'm still able to eat a normal size meal if I chew well. The VG band definitely requires fine tuning. I keep reminding myself to be patient.

A big part of the problem is that some doctors do not follow the Allergan recommendation for a 4.0CC first fill for a VG band.

Your before and after photos are awesome. Inspiring. You mention Allergan regarding the VG band. I want to do some research on the VG band, but when I googled Allergan, nothing specific about the VG band came up. Do you have some suggestions for sites I can check out? Thanks.

Your before and after photos are awesome. Inspiring. You mention Allergan regarding the VG band. I want to do some research on the VG band, but when I googled Allergan, nothing specific about the VG band came up. Do you have some suggestions for sites I can check out? Thanks.

In terms of how they work, all the Allergan (Inamed) Lap-Bands are the same. The differences are in the size of the band and the capacity of saline. There are major differences between the older bands and the newer "AP" series of bands. You might want to contact Allergan directly, but in all likelihood they are going to refer you to your doctor.

I was banding in Sept and I am relatively new to this site. What does Pb'ing mean?

Wendell,

What does it mean when people say "sweet spot". I have had two fills. My first was for 1cc and my second was .5cc one month later. I don't feel like I lose 1-2 lbs in a week, it is more like 1-2 lbs in a month and I get discouraged. Any hints?

I was banding in Sept and I am relatively new to this site. What does Pb'ing mean?

Hi there!

Lap-Band patients have a unique vocabulary to describe different things. Here's a LINK to a great post about the different language that is used:

http://www.lapbandtalk.com/f73/abbreviations-what-they-mean-7959/

To answer your question directly, a "PB" is a "Productive Burp", which is a small amount of vomit.

Wendell,

What does it mean when people say "sweet spot". I have had two fills. My first was for 1cc and my second was .5cc one month later. I don't feel like I lose 1-2 lbs in a week, it is more like 1-2 lbs in a month and I get discouraged. Any hints?

I talked to Inamed about how many CCs in a Lap-Band made for a "Good fill".

Their answer surprised me:

"It really doesn't MATTER how many ccs are in the band. The only thing that matters is whether or not that CC amount provides EFFECTIVE RESTRICTION" (Emphasis added)

So the trick then is NOT how many CCs are in the Lap-Band, it's whether or not the band works well at that level of fill.

One more thing...

"The Sweet Spot" is just another way of saying "Effective Restriction".

The problem is that people expect "The Sweet Spot" to last.

It doesn't.

And neither does "Effective Restriction"

Not until the entire residual fat-pad on the outside of the stomach muscle is melted off, and that takes TIME.

I talked to Inamed about how many CCs in a Lap-Band made for a "Good fill".

Their answer surprised me:

"It really doesn't MATTER how many ccs are in the band. The only thing that matters is whether or not that CC amount provides EFFECTIVE RESTRICTION" (Emphasis added)

So the trick then is NOT how many CCs are in the Lap-Band, it's whether or not the band works well at that level of fill.

One more thing...

"The Sweet Spot" is just another way of saying "Effective Restriction".

Wendell, I am really wondering how that answer could have surprised you. What did you expect them to say?

That is exactly the response I would have hoped they'd give. A good fill is only "good" for the person for whom it is working well. There is no right or wrong amount, any more than there is any right or wrong shoe size. It is what it is for each person, and can and will change over time as the interior anatomy changes.

Wendell, I am really wondering how that answer could have surprised you. What did you expect them to say?

That is exactly the response I would have hoped they'd give. A good fill is only "good" for the person for whom it is working well. There is no right or wrong amount, any more than there is any right or wrong shoe size. It is what it is for each person, and can and will change over time as the interior anatomy changes.

I was still capable of being surprised back in 2004, which is when I asked them that question. :bounce:

Thank-you for all the information. I don't get my first fill until Dec 7/07. Iam finding that I can eat anything, I am always head hungary. I can't wait for my first fill.

Wendall, thankyou for the excellent summary of fills. I am going to schedule my surgery in 30 minutes and appreciate the info.

Thank-you for all the information. I don't get my first fill until Dec 7/07. Iam finding that I can eat anything, I am always head hungary. I can't wait for my first fill.

Head-hunger is ALWAYS an issue for me. When my band is properly adjusted, it's less of a problem. It took 4 fills for me to even KNOW that I had a Lap-Band, but once the proper level of fill was given, and effective restriction kicked in, physical hunger ceased to be a problem.

Wendall, thankyou for the excellent summary of fills. I am going to schedule my surgery in 30 minutes and appreciate the info.

:whoo:You GO!!!!:whoo:

:biggrin1: