Can’t get a perfect lap band adjustment

Question Below Submitted By:  

Lisa Schmidt (a patient from New York)

Lap Band Fill / Unfill

Lap Band Fill / Unfill

I had my lap band surgery in Jan. 2011 and have lost 32 pounds, but I can’t seem to get a good adjustment.

To my frustration, it took me 5 adjustments before I even felt any tightness. That wasn’t until July. Life was good for 4 weeks, then I couldn’t eat or drink anything.

I was told I must have got something stuck which created an ‘incident.’ They took all the fluid out to let my band relax for a month. Since then I’ve had it adjusted twice and need to go back now again – it’s either too tight or too loose.

I feel like the doctor can’t adjust it just a tiny bit, he always takes too much out or puts too much in.

Anyone else having the same frustration?

And would it be a good idea to search out another doctor that may be able to give me better adjustments?


Expert Responses to the Question Above

Bariatric surgeon at CBGSA , Arcadia , California

by: Dr. Troy LaMar

Hi Lisa,

You have received some good comments from the other respondents so far...

I would agree, tiny fractional fills can be appropriate and work sometimes.

Of note, the band can be difficult to get just right and to be just right for long periods of time. It is just a potential issue with having a foreign body around the top of your stomach...

Finally, you may want to make sure you don't have a band slippage, and may want to find a doc who can use flouroscopic guidance with a barium swallow.

Good Luck,
Troy LaMar MD

los angeles bariatric surgeon

(click here for Dr. LaMar's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Analysis & Cost of Lap Band Surgery (Laparoscopic Adjustable Gastric Band) & Whether It's Right for You
- Gastric Lap Band Procedure


Patient Responses to the Question Above

My adjustment

by: Lesley

I had my band fitted 8 years ago.

I managed ok following various fills.

Sometimes over filled. I have just starred to gain weight again.

I have just gotten a fill up to 7.5ml.

I 'm eating baby food at the moment now on my second day and finding that this is not digesting.

Not sure weather to hang on before going back for an unfill.

By reading these comments it sounds like 7.25 ml a might be the right place for me.

Appreciate any advice.

band vs sleeve

by: Anonymous

Is it recommended if you have had so many issue with the lap band to get gastric sleeve surgery?

Band don't fail me now

by: Anonymous

I have been going through the same thing for abou 8 months now. Can't seem to find that happy medium. I get filled then I get severe indigestion and vomiting to have the band unfilled and gain a few pounds and fill and iunfill again. So frustrated I feel like band isn't working for me anymore


by: Dawn

I had a lap band in 2010, I have lost about 100 pounds which I am very happy about. But I too had an incident where something got stuck and had to have fluid taken out. Since then I've not been able to get the right amount added back. I've gained about 10 pounds now, I'm very unhappy about and not able to lose again?

I'm tossing around the idea of now having a gastric sleeve done and be done with this whole thing! But now I'm not quite sure how my insurance will do anything about covering any of this!!

Very frustrating.

to fill or not to fill

by: Anonymous

I get tenths at this point..very small amounts. One tenth less is not enough, one tenth more and its too tight. I can't get it to the sweet spot. I also know that exercise and lifting make a big difference to me.

I have had my band filled and unfilled more than you can imagine. there seems to be no sweet spot for me. Total fail on the lapband. I have 6.2 and it does nothing. Then I get to 6.3 and it is too much. Yes, they have done 1/2 of a tenth also, which is a tiny amount. no difference. I give up. It has been 5 years of going thru this.

Terribly disappointed in LB.

No saline in your band!

by: Lonicera The Bandit

That's astonishing! Yes, please let us know what's happening there. Sounds like you've had a difficult time. There are quite a few entries on this site of people experiencing problems with too much or too little restriction, please do read them, they might help - and keep in touch.Lonicera The Bandit


by: karon

Hi there,

I also had 5 adjustments and one that went terribly wrong. I woke up at night not swallowing my spit so I was in fact choking, that sounds really harsh but a fact. However, when I went back to correct it, it never did feel right and I lived with the fact that I was sick and never really knowing when I could eat and what I could eat.

My band seems to have a mind of its own. What I could have on a Monday, for instance, would be different the next day but the same food. I've never quite got the hang of my band but I learned to live with it now.

Five years down the line I went for a check and found that my band has no saline in it I'm waiting for the doctor to get back to me will keep you all up to date when I find out what they intend to do

Doctors like that must be confronted

by: Beth

It sounds like you either need to come to terms with this doctor or you need to see if you can go to a different fill doc.The fact is, when you get close to your sweet spot, a .25 fill can be the difference between too loose and just right -- just as you know that a .25 fill can be just a little too much.Your doctor is being overly aggressive.

Normally they should give decent fills in the beginning, but right NOW, you are near enough to your sweet spot that he needs to tread lightly.

He needs to remember 1) that it's YOUR body, and 2) that this constant back and forth (especially if accompanied by PBing/vomiting) can dislodge your band.

I've known a few people who this has happened to.

Since YOU'RE the customer, you should be the one to make the final decision that he take baby steps.

My doc says a cc is about four drops (if memory serves).

Yes, even that one drop in a .25 fill can be the difference between just right and too tight.

Yes you ARE the 'trained person'!

by: Lonicera The Bandit

...Because it's YOUR body and you understand from the inside what it feels like to have a fill of 0.25 versus a 0.50 cc.

When it suits them the clinicians trot out the old chestnut "it's an art not a science", or they tell you "kindly" (huh) that they know best.

Well they don't.

You're listening to your body, they aren't.

At the private hospital where I had a 2-year deal, in the end I would go for my fill to the nurse who had had a gastric band fitted, and truly understood the usefulness of the 0.25 fill.

We would talk as equals about it, and I so miss it now that the deal has ended.You sound like you won't be messed around with, so I've no doubt you'll find your way - I hope you'll tell us how you get on.Lonicera The Bandit

lapband adjustments

by: Anonymous

thanks for the response, I have never been able to convince the doctor to give or take .25. He always goes no less than .50 and explains that .25 is too little to make a difference. And of course what do we know what they do, since we aren't the trained person doing it.

I feel like they treat me as though my questioning what they are doing is unjustified and am made to believe that they know what they are doing and my input is incorrect.

Perhaps your fills aren't small enough

by: Lonicera The Bandit

It took me 18 months to get the fill right - and you're just half that period of time into your gastric band.

There are so many reasons why you can feel too restricted one day and not enough the next, but the most common mistake is this cycle:
(1) You're either over-filled or you've eaten something which has gotten stuck, and in bringing it back up the movement's gotten too violent
(2) So you go to the doctor and ask him to remove enough fill to get you comfortable, forgetting that the violent regurgitation has left your esophagus inflamed - so you have too much removed to make you feel comfortable straight away
(3) Then your esophagus calms down, and oh surprise, you feel too loose, and you can eat almost anything
(4) So you go back to the doctor and get a good fill.... and now go back to (1) above.

The sweet spot is achieved by patience and very small fills - 0.25 of a ml from now on. That gives your body time to adjust and your brain time to understand how much you can and can't eat.There's also the factor that as you lose weight, your insides adjust accordingly, and the sweet spot has to be searched for again.

It probably took you a long time to get to where you plucked up the courage to have the operation - so now you need patience to get to where you want to go.

Lots of luck to you.

Restricted or not?

by: Jackie

I don't know how or what I'm supposed to be feeling.

My MD keeps saying give it time.

I've had my first adjustment 3 weeks ago 5ml.

I take one or two bites, and I can start feeling that choking feeling, I dry heave, then I can pretty much eat normal.

Other times, no problem and I can eat almost like I used to.

I wasn't a big eater to begin with, just the wrong stuff.

I thought that this would allow me to eat slower, then start feeling full faster, and stop.

It has not been that way at all.

Do I need more saline? Less? Am I being to impatient.

I haven't lost a pound!

What symptoms prove my band is too loose or too tight?

by: Maryalice Butler

I am 8 years out of band surgery. Lost 85 lbs but gained 30 back (yuck)! I seem to not be able to realize my sweet spot again.

Gastric Band Adjustment

by: Billy Shears

I've been reading about fills and getting the band emptied this is really not very accurate.

I've had a band for 9 years and in order to find a happy medium for my band it was done by adding or removing small amounts eg 0.3ml.

One time I had 0.5ml taken out and my weight increased by nearly 2 stone in a very short time.

I then had 0.3 ml put back and now everything is back to normal.

I'm reading about filling and emptying and that doesn't sound right.

It's all down to fractions of a ml anything more then you can expect drastic changes in your weight up or down.

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