Plastic Surgeons in Beverly Hills - Los Angeles - Plastic Surgery

LAP-BAND®

LAP-BAND® FAQs

• What is the LAP-BAND® System?
• How does the LAP-BAND® System work?
• What happens during the surgery?
• How long does recovery after surgery take?
• Is the LAP-BAND® System new?
• Why is the LAP-BAND® System considered adjustable?
• How is the LAP-BAND® different from gastric bypass surgery?
• What are the possible surgical complications of the LAP-BAND® procedure?
• Do I qualify for LAP-BAND® System surgery?
• How much weight will I lose?
• When will I start to see results?
• Will I feel deprived or hungry?
• Will I be able to eat whatever I want?
• Does the LAP-BAND® System limit physical activity?
• Does insurance cover the LAP-BAND®?
• What are the steps for a patient to get LAP-BAND® System surgery at your practice, starting with their initial call?
• What distinguishes your practice from the competition (why should a patient choose your practice)?
• Isn’t the LAP-BAND® a lot cheaper in Mexico?

What is the LAP-BAND® System?

The LAP-BAND® System is an adjustable gastric band designed to help you lose excess body weight, improve weight-related health conditions and enhance quality of life.
Points to Consider:
The LAP-BAND® System is the number one selling adjustable gastric band worldwide.
The LAP-BAND® AP is a third generation technology, with significant advances over previous versions (360º OmniForm™ technology, low pressure, unlockable buckle, etc.). LAP-BAND® System is made of silicone, a safe and inert substance. There are no recorded cases of an allergic reaction to silicone.

Back to top

How does the LAP-BAND® System work?

The LAP-BAND® System is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced. The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stoma is smaller, you feel full faster, while the food moves more slowly between your upper stomach as it is digested. As a result, you eat less and lose weight.
Points to Consider:
The LAP-BAND® System is a purely restrictive procedure, with no malabsorptive component. This means that your digestive system works the same as before.
For the LAP-BAND® System to work it must be properly adjusted.
The LAP-BAND® System is a tool, and requires patient commitment, regular follow up, and strong practice and surgeon support if it is to be successful.
Although the LAP-BAND® System is reversible, it is intended to remain in place for the life of the patient. Patients who have their LAP-BAND® removed will typically regain weight.

Back to top

What happens during the surgery?

During the procedure, surgeons use laparoscopic techniques (making tiny incisions and inserting long-shafted instruments, including a narrow camera through “ports”) to wrap the LAP-BAND® System around the patient’s stomach. Like a wristwatch, the band is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach and sewn into place.
Points to Consider:
In extreme cases, the procedure may be converted to an open procedure (vs. laparoscopic).
Surgery generally takes about an hour (or less).
Improvements in the device and surgical technique have resulted in a very safe and effective procedure.
The procedure is completely reversible.

Back to top

How long does recovery after surgery take?

If the LAP-BAND® System surgery is performed laparoscopically, as it most frequently is, patients typically spend less than 24 hours in the hospital. It takes most patients about a week before they can return to work, and 4-6 weeks before they can resume exercising. In the case of open surgery or complications (which are rare), recovery may take longer.
Points to Consider:
High risk patients (High BMI, older patients, patients with many severe comorbidities) are may require more time and the hospital and may take longer to recover.
Outpatient settings typically have different patient selection criteria and different protocol for length of patient stay.

Back to top

Is the LAP-BAND® System new?

The LAP-BAND® System has been around since 1994, and over 350,000 have been implanted worldwide. The LAP-BAND® System was FDA approved in the U.S. in 2001, and is rapidly becoming one of the most popular options for weight loss surgery.
Points to Consider:
LAP-BAND® Surgery has been clinically proven as a safe and effective weight loss procedure.
Adjustable gastric banding is estimated to be the number one type of weight loss surgery in the U.S. by 2010.
Awareness of the LAP-BAND® System has increased greatly over the past two years due to Allergan’s consumer and physician awareness programs.

Back to top

Why is the LAP-BAND® System considered adjustable?

Once placed around the stomach, tubing connects the LAP-BAND® System to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma size by adding or removing saline (salt water) inside the inner balloon through the access port. Adjustments are performed without any additional surgery.
Points to Consider:
The average patient will have 4-6 adjustments in their first year after surgery, and 1-3 per year after that.
The average patient will have 3 adjustments before reaching the “Green Zone” (optimal adjustment volume).
Patient sensitivity to the device varies, and some may require far more, or far fewer adjustments than the average, but all patients should come in for regular follow up visits.
The port is sutured (sewn) to the muscle layer beneath the patient’s skin and fat. It is generally not visible at the time of surgery. For patients who lose significant weight, the port may eventually become visible as a “little bump” beneath the skin.

Back to top

How is the LAP-BAND® different from gastric bypass surgery?

Unlike the gastric bypass surgery, the LAP-BAND® System procedure does not require stomach cutting or stapling or gastrointestinal rerouting to bypass normal digestion.
Points to Consider:
LAP-BAND® System is 10 times safer and has 1/10 the serious complications of gastric bypass.
LAP-BAND® System procedure is frequently done as an outpatient procedure, with a quicker return to normal activity than the gastric bypass.
LAP-BAND® System is reversible and adjustable.
Weight loss at three years is very comparable for both procedures.

Back to top

What are the possible surgical complications of the LAP-BAND® procedure?

The most commonly discussed complications are slips and erosions. Slips occur when the lower part of the stomach “slips” up through the band, creating an enlarged upper portion. Erosions occur when the band erodes into the stomach. The rate of serious complications with the LAP-BAND® System is 0.2%, and is significantly decreasing with improvements in the device, surgical technique and patient care.

Back to top

Do I qualify for LAP-BAND® System surgery?

The LAP-BAND® System can help adults, at least 18 years old, who are 100 pounds over their ideal body weight or have a Body Mass Index (BMI) of 40 or greater. People with a BMI of 35 or greater with weight-related health problems may also be eligible for the LAP-BAND® System.
Points to Consider:
Criteria vary by state and payer. A patient who meets the criteria above may not necessarily meet the criteria required by their insurance provider.
Ultimately, it is the surgeon’s decision as to who qualifies for surgery. Check with your surgeon to ensure that you are clear on his selection criteria, and make sure not to promise that a patient can have surgery just because they meet the criteria above.
Outpatient settings (surgery centers) will typically have additional criteria related to patient selection, e.g. upper BMI limit, and restrictions related to the general, respiratory and cardiac health of the patient.
Patient should demonstrate a commitment to lifestyle change, and an ability to understand the procedure and what is required of them.

Back to top

How much weight will I lose?

Weight-loss results vary from patient to patient. A weight loss of two to three pounds per week in the first year of the operation is possible, but one pound a week is more likely. Twelve to eighteen months after the operation, weekly weight loss is usually less. But remember that you should lose weight gradually. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.
Points to Consider:
Follow-up is the key to long term success with the LAP-BAND® System.
The LAP-BAND® System is a tool that helps the patient to feel full for longer on smaller meals. However, it is up to the patient to make the best use of this tool (appropriate food choices, exercise, etc.).
Proper adjustment of the LAP-BAND® System is required for patients to receive the full benefit of the surgery.

Back to top

When will I start to see results?

Individual weight loss results vary but if you follow the general nutritional guidelines, you should expect to lose about 1 to 2 pounds every week on average over the first year.
Points to Consider:
Most patients will lose weight immediately due to the dietary restrictions following surgery (transition from liquid to solid foods). This will help them “jumpstart” their weight loss, but may also leave them feeling hungry or unsatisfied.

Back to top

Will I feel deprived or hungry?

If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived.
Points to Consider:
Patients complaining of hunger, or who are able to eat larger meals without a sense of restriction, are likely in need of an adjustment and should be scheduled for a visit.
Patients may feel hungry during the first 4-6 weeks following surgery as they transition to solid food. Liquids and soft foods pass easily through the stoma (stomach opening) and do not create an early feeling of satiety. During this period, it is important to have patients focus on their weight loss, and to let them know that this transition is necessary for their safety and for the LAP-BAND® to heal properly in place. If a patient is extremely hungry or unhappy, it may be advisable for the patient to meet with the surgeon.

Back to top

Will I be able to eat whatever I want?

You may eat most foods that don’t cause you discomfort. However, because you can only eat a little at any given time, it is important to include foods rich in important vitamins and nutrients – foods such as those recommended by your surgeon and/or dietician.
Points to Consider:
Patients often have difficulty with fibrous (stringy, tough vegetables, especially the skins) foods. The fibers can get trapped half-above and half-below the stoma, leading to discomfort.
Patients often have difficulty with foods that do not break down well even when thoroughly chewed (doughy bread, tough or dry meat). These foods do not pass easily through the stoma, and can lead to discomfort or vomiting.
Patients should not have carbonated beverages.
Patients should generally avoid foods high in calories and low in nutritive content (junk food).

Back to top

Does the LAP-BAND® System limit physical activity?

No. The LAP-BAND® System does not limit or hamper physical activity. You should be able to do everything from simple stretches to strenuous exercises. Always check with your doctor about the amount and type of exercise that is best for you.
Points to Consider:
Patients who maintain regular physical activity generally have improved weight loss and health.
Most patients will be able to return to work within one week (or less) or having the LAP-BAND® System procedure.
The LAP-BAND® System is frequently performed as an outpatient procedure, with many patients going home within a few hours after surgery.

Back to top

Does insurance cover the LAP-BAND®?

Most major insurance providers, including Medicare, cover the LAP-BAND® System for patients that meet the standards set by the FDA (see above). Coverage varies by payer, and is also dependant upon your employer’s specific insurance policy.
Points to Consider:
If possible, offer to verify the patient’s coverage for them. Allergan’s Reimbursement Hotline is available to assist you with this process.
Be aware of the requirements of the primary payers in your area, as well as the time it typically takes for you to get a patient approved and into surgery.
Many payers require a patient to undergo medically supervised weight loss prior to surgery (typically for six months), and this process can significantly delay the process.
Many insurance denials are appealable, and Allergan’s Reimbursement Hotline is available to assist you with this process.
If a patient’s policy has a specific exclusion for bariatric coverage, their best option is to contact their Human Resources Department. However, they will likely have to pay cash if they wish to have the procedure.
This is an opportunity to discuss the option of paying cash for the procedure and whatever financing programs you have available.

Back to top

What are the steps for a patient to get LAP-BAND® System surgery at your practice, starting with their initial call?

The first step is to come in for a free seminar. At the seminar we will provide you with information about the procedure, and you will have an opportunity to meet the members of our team who will provide you with the support you need before and after surgery. Once you have made the decision to move forward, we will verify your insurance coverage and schedule you for a consultation with our surgeon. We will walk you through the process required for insurance approval and clearance for surgery. This includes several standard medical tests as well as a consultation with our psychiatrist, with the whole process typically taking about three months for our motivated patients.

Back to top

What distinguishes your practice from the competition (why should a patient choose your practice)?

Our surgeons area board certified laparoscopic surgeons, and has performed thousands of LAP-BAND® System surgeries. We have a dedicated OR team to so that the procedures go safely and smoothly. More importantly, at Bariatric Practice USA, we recognize that the surgery is just the first step in a lifelong process. Our caring and experienced staff is here to support you along every step of your weight loss journey, and our comprehensive approach helps our patients to make the most of their procedure and to reach their goals for their health and their lives.

Back to top

Isn’t the LAP-BAND® a lot cheaper in Mexico?

While the LAP-BAND® System is cheaper in Mexico, the surgeons there are not currently offering the most advanced device (LAP-BAND® AP). More importantly, follow up is critical to success with the LAP-BAND®, and for most patients the cost and difficulties involved in frequent travel to Mexico will prevent them from getting the care they need. The surgery is a life-long investment, and any initial savings can easily be offset by poor weight loss or complications due to lack of follow up.

Back to top