Trace Curry

In my experience, a panniculectomy in patients with a BMI less than 40 is usually not needed for medical reasons, but many times these patients look fantastic and want it for cosmetic reasons. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Our cost (I say "our" meaning the hospital, who put it together) is $16,500. This includes fills for a year. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

It's not quite as bad as you think when you break it down. Around here insurance pays about $8000 to the facility, $2000 to the surgeon, and $1000 to anesthesia. So that's around $11,000. With my practice, at least, the self pay patients get a pre-op visit, a consent visit, and as many fills as they want for a year. This usually equals about 8-10 altogether, which would probably be another couple of thousand bucks getting up to around $13,000. The reason we take a little less from insurance companies is that we don't have any choice in the matter, the way medicine has evolved they can tell us what to charge. Imagine if you called a plumber and said my toilet is clogged, and I know you charge $200 to unclog it, but I'm going to pay you $100, and if you don't like it tough because you're under contract with me so you have to. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Without seeing Xrays and such, it's hard to speculate on what's going on specific to your situation. The only thing I would say is that I wouldn't really recommend leaving a slipped band in place unless it was unfilled. Good luck, Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

If you have a severe case, probably not. If it's mild and you don't need steroids, probably so. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I don't think coughing would cause any problems with the band, but repeated vomiting if you had some kind of virus certainly could. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Yes, overeating consistently and vomiting consistently can stretch the pouch. Stitches are only so strong, just like you can tear stitches out of clothing you can tear them out of the stomach as well! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I've seen a fair number of incisions like this, I agree with your surgeon in that it does not look like a deep infection. I also agree with him that antibiotics are a good idea for a few days. Might not be a bad idea to clean it with peroxide and put neosporin on it twice a day. Any signs of it getting worse see him right away. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I don't think erosion has anything to do with immune tolerance. I think it's a mechanical thing, like why does a pothole appear at a certain place in the road - it's a combination of factors from the road, the traffice it gets, the weather it sees, etc. As far as why autoimmune disorders are a contraindication, it might be because those patients sometimes have problems with esophageal dysmotility. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

This is the same thing as a slip. It's certainly not good, but it happens. Should be fixable. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Cheryl, Sorry to butt in here, I usually just hang out on the complications forum. Unfortunately, you were probably banded before surgeons made the change in technique from perigastric to pars flaccida. Posterior slips where very common with perigastric technique. With the advent of the newer placement technique, they are rare now. You are right, they can be hard to diagnose. Good luck! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Another tough one, you guys are really making me earn my keep! Providing your band is not slipped, the next most common thing to cause this would probably be a missed hiatal hernia. Dr. George Fielding, probably the world's most prominent band surgeon (and also Australian) has been talking about this a lot at meetings. Sometimes the hiatal hernias can be fairly small and easy to pass over if you don't actively look for them. This is obviously just speculation. Have you tried simethicone? It's a medication that helps to absorb extra gas in the stomach. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I let patients do light cardio in a week, full exercise in 2 weeks. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Wow, this is way too complicated for me to figure out here, but some people have something called esophageal dysmotility, which means that your esophagus doesn't propel food downwards very well. It may have been minimally symptomatic prior to banding, but once the band gets on there and there is some resistance to food going down, suddenly it becomes very symptomatic. There is no choice in these patients but to remove the band. Fortunately, it's not a very common condition. Short of that, the band could be out of position, or it could be that you had a 4cc band and needed a 10cc band. Whatever the cause, I hope you find a solution soon! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Not filling a band for the first year is nuts...never heard of that! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I can't really comment without seeing it. Can you post a digital pic? Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I don't see why you'd be any more or less likely to slip if the surgery was succesful. Just follow the rules like any bandster, avoid PB's if you can and don't eat to the point of discomfort. Good luck! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

In my opinion (just an opinion) if you caused some damage you would have had some kind of pain or forceful vomiting. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Thanks, John, check out the new website! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

I think I just answered this over on the ObesityHelp lap band board! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

The reason it varies from surgeon to surgeon is that it's more of an art than an exact science. There also may be differences in how surgeons place their band (e.g. how much fat they peel away before they lock the band down making it looser or tighter). The reason for it is that there is always some post-surgical swelling of the tissue inside the band. This gives you the same kind of restriction as if you had a fill in your band, only it's the swollen stomach tissue pushing out instead of the band pushing in. The sutures that are placed to make the "belt loops" to hold the band in place can easily come out if stressed too much. If you break the rules and get a big old hunk-a-steak stuck in there and start forcefully vomiting, you might rip out the stitches and end up with an early slip. Hope that all makes sense! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Bands have been in for around 15 years world-wide. Unless there is a slip or an erosion, it doesn't appear that there is any real damage to the stomach. This doesn't mean that if you took the band out the stomach would look completely normal however, you'd be able to see where the band was but it wouldn't really affect the function of the stomach typically. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Thanks, Sherri. I'm very proud of the aftercare we provide and am glad we can now offer it to any patient, not just those I've operated on! Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

There have been recent improvmenets in how the band was placed (Google perigastric technique and pars flaccida technique). This doesn't really relate to suturing, but the newer technique has reduced the rate of slippage dramatically. Dr. C Cincinnati, Ohio www.TheBandDoctor.com 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

Sometimes cases of pouch dilation will resolve by leaving the band unfilled for awhile, sometimes not. It's really important for bandsters to recognize that feeling of fullness and stop early so as not to put major stress on the band position. If it's not really pouch dilation but what's known as a concentric slip, it probably requires repositioning (meaning surgery). Good luck, Dr. C Cincinnati, Ohio 877.442.BAND DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!