Question:
Why different sizes for lapband and realize band?

I've seen others posting about size of the band and/or how many cc's filled in a certain cc sized band, but I've yet to see any explanation of why the differences and how/why a surgeon chooses which one for which patient. Any insight?    — Libby R. (posted on May 24, 2009)

May 24, 2009
From my understanding, band size has a lot to with the initial weight of the patient. If you are very obese, the doctor will usually use a larger band because (1) the stomach is stretched/larger, so the bigger band will be needed to fit around the stretched stomach and (2) the larger band will allow for more adjustments over time as you lose weight. For a smaller patient, they can use a smaller band because (in theory) the stomach is smaller, and the patient will get restriction better/sooner if the doctor starts with a smaller band. Some doctors use the same size band on most Lap band patients (the "medium"/"standard" which takes about 10 ccs). Unfortunately, there is no perfect way to predict the number of adjustments a person will need with either kind of band. For example, you can take two patients starting at the same BMI and one might feel restriction at 4 ccs while the other does not, even though they have the same band. NOTE: The doctor also usually considers other factors when deciding which band to use. For example, if the person has a lot of upper abdominal obesity, they doctor may use a larger band because it makes the surgery easier/safer to do. A lot of surgeons generally use the large band on men, partly because they carry their weight higher and are more apple-shaped. Doctors also consider issues like the size of the port. The port of the lap band is larger (i.e. taller) than the port of the Realize band, so in very obese patients, sometimes doctors like to use the Lap band so it is easier to get fills. If I remember correctly, I *think* the AP lap band comes in 3 sizes (4 cc, 10 cc, and 14 cc). The Realize band comes in two sizes, the second of which is called the Realize-C. The Realize-C is the larger of the two. I have the Realize C. Okay, I think I have exhausted all of my "band sizing knowledge". Good luck on your journey.
   — ads2e

May 25, 2009
I do have some insight on the difference in Band sizes and have seen first hand the reasons surgeons should be careful when choosing the right size for a particular patient. My husband had the LapBand a little over 4 yrs ago and at time of surgery weighed 440lbs. He was given the "smaller" of the 2 different sizes (back then I dont think the Realize Band was used at all) Well, from day one my husband had bad complications. He had to stay in the hospital for 1 month b/c he was unable to even swallow his own spit due to his Band being way too tight. After the initial swelling from surgery and just time itself the Band stretched out and he was atleast able to drink. I first met him one year after his surgery and saw some of the problems and frustrations he went through b/c of the smaller Band. His surgeon had even admitted to him that he should have went with the LARGER Band but that my husband was one of those the doctor felt was right on the fence as to what size to use and he mistakenly chose the wrong one. I on the other hand was 345lbs day of surgery and was given the larger Band. I first thought wow, I was 100lbs LESS than my husband and I was given the bigger band. It really concerned me at first b/c I thought this meant I was going to be able to eat more than I should and it wasnt going to have the right restriction that I knew I needed to be successful, but after talking to my surgeon he said he went with the larger band b/c I had some extra "fat tissue" around my stomach and not to worry this would actually work to my advantage. He said with too tight a band size you may have vomiting, pain while eating or drinking, or band slippage. Also the larger band leaves more room to play around with for the "fills" So I am actually glad he made the logical decision and gave me the larger one. BTW my surgeon did not even know what kind of band he would give me until he was "in there" and looking for himself.....which makes since if you think about!!! Definetly ask your surgeon how HE/SHE chooses the best size and listen closely to the reasons b/c I know my husband has said many times he would not have wished his complications on his worst enemy! Good luck with evrything!
   — ashley32n

May 25, 2009
Thank you to both of you for taking the time to post such detailed answers. I've learned a LOT! One thing I do know is that my surgeon only uses the LapBand, never the Realize Band. So now I am anxious to ask him more about what size and why. Thank you, thank you!
   — Libby R.