Expert Revisional Bariatric Surgery from a Johns Hopkins-Trained Fellowship Specialist
Revisional Bariatric Surgery is a highly specialized procedure offered at Lalezari Surgical in Los Angeles for individuals who have previously undergone weight loss surgery but did not achieve the desired outcomes or have experienced complications. Dr. Sepehr Lalezari, MD, FACS, brings exceptional expertise to this complex field through his fellowship training from Johns Hopkins Medicine, eight years of specialized bariatric practice, and extensive published research in surgical outcomes and complications management. As a board-certified surgeon recognized as a Los Angeles Magazine “Top Doctor” (2021-2024) and SUPERDOCTORS “Rising Star” (2023-2025), Dr. Lalezari leverages his comprehensive expertise to correct or modify initial weight loss surgeries, enhancing both results and patient satisfaction.
Dr. Lalezari’s unique qualifications in revisional surgery stem from his extensive experience with both primary bariatric procedures and complex revision cases. His published research includes studies on post-operative complications, surgical technique optimization, and patient outcome improvement, making him uniquely qualified to address the challenging aspects of revisional bariatric surgery that many surgeons prefer to avoid.
Understanding Revisional Weight Loss Surgery
Revisional Bariatric Surgery is a sophisticated subspecialty within bariatric surgery that requires exceptional surgical skill and comprehensive understanding of anatomy, physiology, and the long-term effects of various bariatric procedures. Dr. Lalezari’s fellowship training at Johns Hopkins Medicine provided intensive exposure to complex revisional cases, making him one of the most qualified revisional bariatric surgeons in Los Angeles.
This specialized surgery is tailored to address various issues such as inadequate weight loss, weight regain, or complications from an original bariatric surgery like gastric bypass, sleeve gastrectomy, or Lap-Band. Revisional surgery can involve converting one type of surgery to another, correcting structural problems, addressing anatomical complications, or even re-doing the original procedure to ensure its effectiveness and safety.
Common Reasons for Revisional Surgery
- Inadequate Weight Loss or Weight Regain
- Less than 50% excess weight loss after 18-24 months
- Significant weight regain after initial success
- Metabolic factors preventing continued weight loss
- Anatomical issues affecting restriction or malabsorption
- Technical Complications
- Lap-Band slippage, erosion, or port complications
- Gastric bypass anastomotic strictures or leaks
- Sleeve gastrectomy dilation or reflux development
- Pouch enlargement or outlet dilation
- Medical Complications
- Severe gastroesophageal reflux disease (GERD)
- Nutritional deficiencies resistant to supplementation
- Dumping syndrome or hypoglycemic episodes
- Marginal ulceration or chronic complications
- Quality of Life Issues
- Food intolerance or eating difficulties
- Chronic pain or discomfort
- Psychological impact of surgical failure
- Desire to optimize health outcomes
Why Choose Dr. Sepehr Lalezari for Your Revisional Surgery?
- Exceptional Training and Credentials
Dr. Lalezari’s credentials are exemplary. He completed his specialty fellowship training in Bariatric and Minimally Invasive General Surgery at Johns Hopkins Medicine, one of the world’s leading medical institutions renowned for complex surgical procedures and innovation. This prestigious training provided extensive exposure to the most challenging revisional cases and advanced surgical techniques.
- Published Research and Expertise
Dr. Lalezari’s published research includes peer-reviewed articles addressing:
- Prevention of incisional hernia complications in revisional surgery
- Management of complex post-operative scenarios
- Optimization of surgical techniques for improved outcomes
- Patient selection criteria for revisional procedures
- Board Certification and Recognition
- Fellow of the American College of Surgeons (FACS)
- Los Angeles Magazine “Top Doctor” recognition (2021-2024)
- SUPERDOCTORS “Rising Star” awards (2023-2025)
- Active member of SAGES (Society of American Gastrointestinal and Endoscopic Surgeons)
- Regular presenter at major bariatric surgery conferences
- Comprehensive Surgical Experience
Dr. Lalezari’s approach combines cutting-edge surgical techniques with a compassionate understanding of patients’ needs, ensuring a high standard of care and improved surgical outcomes. His experience includes:
- Complex gastric bypass revisions
- Lap-Band to sleeve or bypass conversions
- Sleeve gastrectomy revision and optimization
- Duodenal switch and SADI-S conversions
- Management of post-operative complications
Types of Revisional Bariatric Surgery
- Lap-Band Revisions
Lap-Band Removal and Conversion Dr. Lalezari frequently performs conversions from failed Lap-Band procedures to more effective options:
- Lap-Band to Sleeve Gastrectomy: Most common conversion for band-related complications
- Lap-Band to Gastric Bypass: Preferred for patients with severe GERD or diabetes
- Band Removal Only: For patients requiring band removal without immediate conversion
Common Band Complications Addressed:
- Band slippage requiring repositioning or removal
- Band erosion into the stomach
- Port site complications or tubing problems
- Esophageal dilation from chronic obstruction
- Gastric Bypass Revisions
Pouch and Outlet Revision
- Gastric pouch reduction for pouch enlargement
- Outlet revision for anastomotic dilation
- Limb length adjustment for inadequate weight loss
- Conversion to distal bypass for enhanced malabsorption
Complication Management
- Marginal ulcer treatment and prevention
- Anastomotic stricture correction
- Internal hernia repair
- Nutritional deficiency optimization
- Sleeve Gastrectomy Revisions
Sleeve Optimization Procedures
- Sleeve re-resection for dilation or weight regain
- Conversion to gastric bypass for GERD management
- Conversion to SADI-S or duodenal switch for enhanced weight loss
- Hiatal hernia repair with sleeve revision
GERD Management in Sleeve Patients Dr. Lalezari’s expertise includes specialized techniques for managing reflux disease in sleeve gastrectomy patients, including conversion to bypass when necessary.
- Advanced Revision Procedures
Duodenal Switch and SADI-S For patients requiring maximum weight loss and metabolic improvement:
- Sleeve to duodenal switch conversion
- Sleeve to SADI-S conversion
- Bypass to duodenal switch conversion
- Complex limb length adjustments
Benefits of Revisional Bariatric Surgery Under Expert Care
- Enhanced Weight Loss Potential
For patients who have not achieved significant weight loss or have regained weight, revisional surgery under Dr. Lalezari’s expert care can offer a new opportunity to lose weight effectively. His comprehensive approach addresses both technical and metabolic factors contributing to suboptimal outcomes.
- Resolution of Complications and Quality of Life Improvement
Dr. Lalezari’s expertise addresses a wide range of issues including:
- Acid reflux and GERD management
- Nutritional deficiency correction and optimization
- Mechanical problems like slippage or erosion
- Chronic pain or eating difficulties
- Psychological impact of surgical failure
- Improved Overall Health Outcomes
Correcting or optimizing the initial surgery under expert care can significantly improve:
- Long-term weight maintenance
- Resolution of obesity-related comorbidities
- Overall health, mobility, and self-esteem
- Quality of life and functional capacity
- Advanced Surgical Techniques
Dr. Lalezari employs the most advanced minimally invasive techniques including:
- Single-incision laparoscopic approaches when appropriate
- Enhanced recovery after surgery (ERAS) protocols
- Advanced suturing and anastomotic techniques
- Comprehensive leak testing and safety measures
Is Revisional Bariatric Surgery Right for You?
Clinical Candidacy Criteria
Candidates for revisional surgery under Dr. Lalezari’s care typically include those who:
- Weight-Related Indications:
- Have not achieved adequate weight loss (less than 50% excess weight loss) 18-24 months post-surgery
- Have regained significant weight after initial success
- Continue to struggle with obesity-related health conditions
- Desire optimization of metabolic outcomes
- Complication-Related Indications:
- Are experiencing medical complications or adverse effects from their first surgery
- Have mechanical problems requiring surgical correction
- Suffer from severe GERD or eating difficulties
- Experience chronic pain or quality of life impairment
- Medical Evaluation Requirements:
- Have been evaluated by Dr. Lalezari and deemed suitable for revision based on health status and surgical history
- Demonstrate psychological readiness for revisional surgery
- Show commitment to post-operative lifestyle changes
- Have realistic expectations about outcomes
Comprehensive Pre-Operative Evaluation
Dr. Lalezari’s evaluation process includes:
- Detailed review of original surgical records and operative reports
- Advanced imaging studies (CT scan, upper GI series, endoscopy as indicated)
- Comprehensive laboratory evaluation including nutritional markers
- Psychological assessment and readiness evaluation
- Multidisciplinary team consultation
Correcting Previous Weight Loss Surgery: What to Expect
- Phase 1: Comprehensive Evaluation and Planning
- Detailed review of your surgical history and previous procedures
- Analysis of weight loss patterns and current health status
- Physical examination and assessment of surgical anatomy
- Discussion of symptoms, complications, or concerns
- Review of previous imaging studies and operative reports
Advanced Diagnostic Testing Depending on your specific situation, Dr. Lalezari may recommend:
- Upper GI series to evaluate anatomy and function
- CT scan to assess for complications or anatomical issues
- Upper endoscopy for direct visualization
- Comprehensive laboratory studies including nutritional markers
- Psychological evaluation to assess readiness for revision
- Phase 2: Tailored Surgical Planning
Customized Surgical Approach Based on your unique needs and Dr. Lalezari’s extensive experience, he will devise a customized surgical plan that may involve:
- Converting the existing procedure to a more effective option
- Making specific technical adjustments to optimize function
- Using advanced techniques to address complications
- Planning staged procedures if necessary for safety
Risk Assessment and Optimization Dr. Lalezari’s comprehensive approach includes:
- Thorough risk-benefit analysis specific to your case
- Pre-operative optimization of medical conditions
- Nutritional assessment and correction of deficiencies
- Coordination with other specialists when necessary
- Phase 3: Expert Surgical Execution
Advanced Surgical Techniques Dr. Lalezari employs state-of-the-art minimally invasive techniques including:
- Laparoscopic and robotic approaches when appropriate
- Advanced suturing and anastomotic techniques
- Comprehensive adhesiolysis and anatomical restoration
- Intraoperative leak testing and quality assurance measures
Safety Protocols and Monitoring
- Comprehensive intraoperative monitoring
- Advanced anesthesia protocols for complex cases
- Immediate post-operative imaging when indicated
- Enhanced recovery after surgery (ERAS) protocols
- Phase 4: Comprehensive Follow-Up Care
Immediate Post-Operative Period
- Close monitoring in our advanced recovery facility
- Early mobilization and enhanced recovery protocols
- Comprehensive pain management strategies
- Nutritional optimization and supplementation guidance
Long-Term Follow-Up and Support Post-operative care is crucial for recovery and long-term success. Dr. Lalezari’s team at Lalezari Surgical ensures:
- Regular follow-up appointments with comprehensive evaluation
- Ongoing nutritional counseling and supplementation management
- Psychological support and behavioral modification assistance
- Long-term weight and health monitoring
- Access to support groups and educational resources
Advanced Revision Techniques and Innovations
- Minimally Invasive Approaches
Dr. Lalezari specializes in minimally invasive revisional techniques that offer:
- Reduced operative time and surgical trauma
- Faster recovery and return to normal activities
- Lower complication rates compared to open approaches
- Improved cosmetic outcomes with smaller incisions
- Complex Anatomical Reconstruction
For challenging cases, Dr. Lalezari’s expertise includes:
- Advanced adhesiolysis and anatomical restoration
- Complex anastomotic reconstruction
- Multi-stage surgical planning when necessary
- Innovative problem-solving for unique anatomical challenges
- Metabolic Optimization Strategies
Beyond technical revision, Dr. Lalezari focuses on:
- Optimizing malabsorption and restriction balance
- Addressing hormonal and metabolic factors
- Coordinating care with endocrinologists when needed
- Long-term metabolic monitoring and adjustment
Frequently Asked Questions About Revisional Bariatric Surgery
Success rates vary depending on the specific revision performed and individual patient factors. Dr. Lalezari's extensive experience and careful patient selection optimize outcomes, with most patients achieving significant additional weight loss and complication resolution.
Revisional surgery typically carries higher risks due to scar tissue and altered anatomy. However, Dr. Lalezari's fellowship training and extensive experience in complex cases minimize these risks while maximizing potential benefits.
Recovery varies depending on the complexity of the revision. Most patients can return to work within 2-3 weeks, with full activity resumption in 6-8 weeks. Dr. Lalezari's minimally invasive techniques often allow for faster recovery times.
Coverage varies by insurance provider and the specific medical indication for revision. Our insurance specialists work closely with providers to document medical necessity and maximize coverage approval.
Most complications can be addressed through appropriate revisional techniques. Dr. Lalezari's comprehensive evaluation will determine the best approach for your specific situation.
The best way to determine candidacy is through comprehensive evaluation by an experienced revisional surgeon. Dr. Lalezari's expertise allows for accurate assessment of revision potential and expected outcomes.
Schedule Your Bariatric Surgery Consultation in Los Angeles
If you believe your initial weight loss surgery did not meet your expectations, or if you are experiencing complications, consider a consultation with Dr. Sepehr Lalezari at Lalezari Surgical. Our comprehensive approach to revisional bariatric surgery addresses the complex challenges that many surgeons are unable or unwilling to manage.
Why Choose Dr. Lalezari for Revisional Surgery:
- Fellowship training from Johns Hopkins Medicine in complex bariatric procedures
- Board-certified FACS with 8+ years of specialized revisional experience
- Published research in surgical complications and outcome optimization
- Los Angeles Magazine “Top Doctor” recognition demonstrating peer recognition
- Comprehensive facility with advanced surgical technology
- Multidisciplinary team approach to complex cases
We are dedicated to providing solutions that address your specific needs and help you achieve your health and wellness goals through expert revisional bariatric surgery.
What to Expect During Your Consultation:
- Personal evaluation by Dr. Lalezari with comprehensive case review
- Analysis of previous surgical records and imaging studies
- Discussion of all available revisional options
- Realistic outcome expectations and risk assessment
- Development of personalized treatment plan
- Insurance verification and financial counseling
Contact us today to explore how revisional bariatric surgery can help you regain control and continue your journey to a healthier life under the expert care of Los Angeles’ most experienced revisional bariatric surgeon.
Dr. Sepehr Lalezari is a board-certified bariatric surgeon with fellowship training from Johns Hopkins Medicine. Revisional bariatric surgery carries inherent risks that vary based on individual circumstances. This information is for educational purposes and does not replace professional medical advice. Individual results may vary. Always consult with Dr. Lalezari or a qualified healthcare provider for personalized medical guidance.
