Weight Regain After Sleeve Surgery? Check Your Revision Options
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Your Revision Surgery Specialist
Dr. Sofiane El Djouzi understands that revision surgery is both a medical procedure and an emotional journey. After 2,400+ successful surgeries, he specializes in giving patients a second chance at lasting weight loss success.
Why Revision Patients Choose Dr. El Djouzi:
- Revision Expert: Specializes in complex cases where first surgeries failed
- Published Authority: Lead contributor to ASMBS national bariatric surgery guidelines
- Proven Results: 2,400+ procedures with less than 2% complication rate
- Insurance Advocate: 95% insurance approval success for revision cases
- Advanced Training: Fellowship-trained in minimally invasive and robotic techniques
- Faster Recovery: Most patients return to work in 2-3 weeks
- Top 1% Nationally: Recognized among America's best bariatric surgeons
"I don't just perform revision surgery – I find out why your first surgery didn't work and create a personalized plan to ensure lasting success this time." – Dr. El Djouzi
Let Dr. El Djouzi evaluate your revision options
Why Take This Assessment
Every patient's journey is unique. This short assessment helps you understand the best next step to overcome weight regain or other issues after sleeve surgery.
Personalized Match
Get a personalized recommendation based on your health profile, lifestyle and goals.
Compare Options
See how re‑sleeve, gastric bypass or other revision options differ, so you can make an informed choice.
Expert Guidance
Leverage 15+ years of experience and more than 2,400 successful surgeries.
Gastric Sleeve Revision Options
Compare the six most popular gastric sleeve revision options side by side.
Gastric Bypass (Roux-en-Y)
- Creates a new shortcut for food, like building a detour road around traffic
- Small stomach pouch connected directly to small intestine
- Helps with steady weight loss and often eases acid reflux and diabetes
- More involved surgery requiring lifelong vitamins and mindful eating
- Many people lose a large share of their extra weight
Re-sleeve Gastrectomy
- Like taking in a stretched outfit so it fits snug again
- Surgeon removes more of the stretched stomach to make it narrow once again
- Shorter, simpler operation that keeps the natural path of food
- People usually see moderate drop in weight and regain sense of fullness
- Results often less dramatic than bypass but helps get back on track
Duodenal Switch (Traditional DS)
- Two-part overhaul: stomach made smaller and food takes shorter route through intestines
- Sleeve first, then reroutes small intestine so food bypasses much of it
- Greatest average weight loss and very high diabetes improvement rates
- Complex surgery requiring frequent bowel changes and strict lifelong vitamins
- Many lose 70 to 80 percent of excess weight and keep it off
SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve)
- Lighter version of duodenal switch with just one loop, like simpler highway bypass
- Makes a sleeve, then connects upper small intestine to lower section with single join
- Strong results with simpler, shorter surgery compared to full DS
- Many patients lose large amounts of weight and improve health in years after surgery
- Offers balance of power and simplicity for people who need more than sleeve
Endoscopic Plication of a Gastric Sleeve
- Like pulling a drawstring tight from the inside without making any cuts
- Uses scope through mouth to place stitches that fold stomach and make it smaller
- No incisions, quick recovery, and option to repeat the treatment
- Most people lose portion of weight they regained and feel full more quickly
- Gentle, safe way to restart progress without undergoing major surgery
Laparoscopic Gastric Plication of a Gastric Sleeve
- Folding and stitching stomach from outside like tightening a belt, without removing tissue
- Uses small keyhole incisions to pleat stomach and make it narrower
- No new staple line, no intestine changes, and option to reverse it later
- Patients may see modest to moderate drop in weight, but effect may fade with time
- Seen as experimental, some patients may still need more standard revision later
Gastric Sleeve Revision FAQs
A gastric sleeve revision is a second surgery done to adjust your original sleeve gastrectomy. It can correct problems such as severe acid reflux, a stretched stomach, or weight regain. Dr. El Djouzi may reshape the sleeve or convert it into another procedure, like a gastric bypass or duodenal switch. The goal is to give you another chance at lasting results.
People who regain significant weight, develop severe reflux, or experience other complications after a sleeve may qualify for revision. Candidates usually still meet bariatric surgery guidelines, like having a BMI over 30 with health problems. Dr. El Djouzi will also consider overall health, lifestyle commitment, and whether there are clear anatomical issues such as a stretched sleeve. If these factors line up, a revision may be a good option.
The two biggest reasons are weight regain and acid reflux. Over time, the stomach can stretch, or patients may not lose enough weight from the first surgery. Some also develop new issues like ulcers or swallowing problems. When this happens, Dr. El Djouzi may recommend a revision to correct the problem and restore results.
Most surgeons, including Dr. El Djouzi, recommend waiting at least 12 months after your sleeve before considering revision, unless there's a medical emergency. This allows time to recover and try lifestyle changes first. If serious complications arise, like severe reflux or a stricture, you should seek help right away. Insurance companies may also require a waiting period before approving another surgery.
Options include re‑sleeving (making the stomach smaller again), converting to gastric bypass, switching to a duodenal switch or SADI‑S, or choosing an endoscopic tightening procedure. Each option has unique benefits depending on whether your issue is reflux, weight regain or anatomy. Dr. El Djouzi will recommend the best path based on your specific needs and health history.
There's no single best option because it depends on your situation. For weight regain without reflux, a re‑sleeve may work. For reflux or modest weight loss, gastric bypass is often recommended. If maximum weight loss is needed, a duodenal switch or SADI‑S may be more effective. Dr. El Djouzi tailors the choice to your body and health goals.
Yes, a re‑sleeve is possible if your stomach has stretched over time. Dr. El Djouzi can remove more of the stomach to restore fullness and help with weight loss. It works best when the stomach is clearly enlarged. However, if you also have reflux, bypass or another option may be better. Tests like an endoscopy help Dr. El Djouzi decide if a re‑sleeve is right for you.
Both options are effective, but they suit different needs. Gastric bypass is often chosen for patients with severe reflux and provides good weight loss with fewer nutritional risks. Duodenal switch or SADI‑S usually leads to the most weight loss but requires stricter vitamin and diet management. Dr. El Djouzi will help you weigh your health needs and long‑term commitment before deciding.
SADI‑S, or Single Anastomosis Duodeno‑Ileal bypass with sleeve, is a simplified version of the duodenal switch. It reduces stomach size and reroutes part of the intestines to promote more weight loss and improve conditions like diabetes. It can be performed after a sleeve as a revision. While effective, it requires lifelong vitamins and can change bowel habits. Dr. El Djouzi may recommend it for patients who need stronger results.
Yes, endoscopic sleeve plication can tighten a stretched sleeve without making incisions. A scope is passed through the mouth to place stitches that fold the stomach and make it smaller. It's less invasive than traditional surgery, with quicker recovery and the option to repeat if needed. However, results may be more modest than surgical revision, and not all patients are candidates. Dr. El Djouzi can determine if this approach is right for you.
Success depends on the reason for surgery and how it's defined. For reflux, converting to bypass works very well, with most patients finding relief. For weight loss, results vary, but many people lose a significant amount again. Overall, about 60 – 80% of patients see meaningful improvements. Dr. El Djouzi will help you understand what success looks like for your case.
For the right person, yes. If you've regained a lot of weight or developed serious problems like reflux or Barrett's esophagus, revision can improve your health and quality of life. It is still major surgery, so risks and commitment matter. Many patients of Dr. El Djouzi who went through revision are glad they did, but he emphasizes the importance of realistic expectations.
In most cases, yes. Gastric bypass reroutes food and acid away from the esophagus, which often improves or eliminates reflux. Many patients notice relief quickly, sometimes right after surgery. Dr. El Djouzi considers bypass the gold‑standard revision for reflux after a sleeve.
Most experts, including Dr. El Djouzi, recommend converting to gastric bypass if Barrett's is diagnosed. Barrett's is caused by long‑term reflux and can lead to cancer if untreated. Bypass greatly reduces acid exposure, giving your esophagus a chance to heal and lowering risks. Dr. El Djouzi works with gastroenterologists to ensure you receive the right care.