How the Lap-Band actually works, fills and refills

[justmermp 6]

Wendell, first let me thank you for your post. I was going in for fill after fill thinking am I the abnormal one. Your post helped me better understand the process. Since being a member here I have shared your post here with several people. Some personal friends who have the band and here in the forum in different areas. Always a link to revert back to your original post. Thank you very, very much!

[Dawn200321 146]

Thank you for posting this!! This is great info to have

[JustDoIt130 369]

My nutritionist said that some saline naturally evaoprates from the band over time as well, which is why even with good restriction you may need a minor tweak now and then.

This is all such good info!! I can wait to be banded!!

[readytogoforit 172]

Thank you for the info,the more I know the better I can deal with the next step!!!

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.

[Pooh plus size 6]

great info because i am in my post op stage and I was getting discourage by the scale but i will give it my best Thanks

[Army's girl 4]

My doctor told me after surgery that he put 3 cc's in with the surgery. He said that this is something that they are staring to do with the new surgeries when the capacity is 10 cc's and above. Has anyone else had this.

yes this is quite the norm.I see bands & bypasses everyday & now they are filling bands 2-3cc's during surgery. I was filled with 2 cc's also & lost 11 lbs my first 7 days!! Keep up the great work.

[P.chan 0]

Hi,

Is the lapband filled with Water or what solution?

[proshooperLinda 7]

They inject a saline solution in to it...

[new chapter in life 5]

Thank you for the info!! Im getting my first fill this coming Wed & it helps to know what to expect.

[bandedbob 1]

I had the Lap Band surgery in October 2010 - so it has been 15-16 months. Initially I had over 35 lbs of weight loss, but never really felt the 'smaller stomach', or 'pouch' so often described. I have limited capacity to exercise because I need a knee replacement (bone on bone / no cartilage / arthritis). I have a broken foot and put on 12-15 pounds over the holidays so I am back here for advice...

I often feel great restriction, especially the first morsel of food in the morning. I have 'frothed' which is the production of massive amounts of saliva to help get food down - and have puked because of this (one time).

I have thrown up from not chewing food sufficiently (especially chicken and smoked salmon) on a dozen occasions and it is quick and not unpleasant, but not desirable. It simply reminds me I cannot 'gobble' food down.

I have been carb restricted due to self imposed limits for 14 months - no bread, Pasta, muffins, subs, pizza etc. but if I splurge on pizza I can eat as much as I want - WHY ?

I have a delayed one year follow-up in 2 weeks and would like to have had more weight loss. When does the effect of the band 'kick in' ...

I feel restriction (almost daily) / I have frothed / I have lost 35 lbs / I have gained 12 lbs / I want to lose 80 lbs / I do not eat at all like I used to (no waffles. no muffins. no snacking, no subs) yet I see no limited progress..

Please share your thoughts and experiences.... when does the band start to 'work' and how do you know it is working ???

[Ninababy 5]

Honey we could be twins! I am in the same mess! It is awful !

[bandedehs 0]

Bandedbob--I feel I am in a similar situation to you. I'm looking for advice as to whether I need another fill or not. Honestly--my surgeon's office staff is really nice & they seem eager to answer questions but they aren't really helping me understand what's going on here. I was banded Oct.2011 & to date have lost a total of 15lbs. Did not have to do any special dieting pre-surgery so my weight was pretty much the same pre-op to surgery date. I am unusual in this way--I can eat more in the morning/lunch time & then at night I can hardly get any solid food down. I am having trouble figuring out if my band is "too tight" at night OR am I not chewing well enough or eating too fast? My husband (very supportive) has tried to observe & give his opinion. He does not think I need another fill. But I only have 3cc's in a 10cc band. My surgeon looked at me like I was crazy when I asked if any Fluid would be put in at time of surgery. He & his staff add fluid ilke it is gold (I guess it kind of is that way to us!)....doing 1/2cc at a time (at least that's been my experience). My husband's concern is that I'm eating so much less (& I've always been a healthy eater....not a junk food/fast food eater) but I'm not seeing much weight loss. I'm walking some but have some serious arthritis conditions preventing me from hard hitting cardio workouts. And I puke almost every night trying to eat some kind of good Protein. Usually something I've cooked. Shredded, chopped, chewed to death (I think) pieces. I have a friend who thinks I do need a tiny little fill to really show me that I'm still eating too fast or swallowing too large of a portion. I just don't know what to do, but I am frustrated. I can still eat a large amt of food during the midday....over the last hour (noon-1pm) I've eaten one of those LARGE cans of tuna w/ low fat mayo & mustard mixed in... And I'm satisfied for now.... But that was probably 1--1 1/2 cups. And about 3 hrs ago I had 3/4 cup of smushed chickpeas. But tonight--I'll barely be able to eat 2 teaspoons of chicken or chili or whatever... ANY IDEAS OR OPINIONS WELCOME!! My next appt is next Friday.

[☠carolinagirl☠ 18,721]

I read your post Wendell, and it answered alot of my questions that were in my head. I did view your pictures. You look wonderful.

[NicoleMcNulty 0]

Omg. Thank you so much. I was banded 10 days ago and really thought it had fallen off orbthe Dr never closed it BC i have no restriction and am starving. Thanks so much for the post. I'm so happy i found this website. I was really.considering going to the emergency room and demanding an drag or ultrasound to see if the band was on or not.

[Grider 92]

I liked your post about the info about the delay... I was wondering about that,,, the Dr did NOT give me a 2nd fill and I was feeling more tightening recently than in the beginning and thought there was some food stuck in there,, great post, and also how the band in it's location of the stomach- sends the brain messages it is full!