Everself SIS
Endoscopic re-tightening of a stretched sleeve.
~15%
Average weight loss
30–45 min
Outpatient procedure
- No incisions. Same-day discharge.
- 1–3 days off work.
- 82% of patients lose ≥10% body weight.
Non-Surgical Bariatric Surgery Revision
Weight regain after weight loss surgery isn't a failure.
Roughly 1 in 5 patients regain significant weight within 5 years of bariatric surgery — not because they did something wrong, but because the surgical anatomy stretches over time. A 30–45 minute non-surgical revision can restart your progress.
As seen in
Find your revision option Step 1 of 3
Which surgery did you have?
~10–15%
Average total body weight loss
30–45 min
Endoscopic, outpatient
No incisions
Through the mouth
12-month
Program included
Why this happens
It's not your discipline. It's your anatomy.
You didn't fail surgery. Bariatric surgery works by physically restricting how much you can eat. Over time, the stomach can stretch, making it easier to eat more and harder to keep weight off.
The pouch stretches.
After sleeve or bypass, the stomach can gradually expand — increasing capacity and bringing hunger back.
The outlet dilates.
For bypass patients, the pouch-to-intestine connection can widen, causing food to empty faster and fullness to fade sooner.
Hunger rebounds.
Weight loss surgery's appetite-suppressing effect can weaken over time. That's biology — not failed willpower.
Two procedures, one program
Pick the revision matched to your original surgery.
Both procedures are endoscopic, outpatient, and wrapped in a 12-month support program. The right one for you depends on what was done the first time.
Everself TORe
Endoscopic reduction of a dilated bypass outlet.
~10–15%
Average weight loss
30–45 min
Outpatient procedure
- No incisions. Same-day discharge.
- 1–3 days off work.
- Reduces the gastrojejunal outlet, restoring satiety.
The doctor who invented this
Born in our Harvard lab. SIS and TORe at their best.
Not all endoscopic revision is the same. Pattern, depth, the hands at the controls — every detail decides how much weight you lose. Everself SIS and Everself TORe are the original protocols, performed by the team that invented them.
Meet the inventor of SIS and TORe, Dr. Christopher Thompson
Harvard Medical School Professor · Everself co-founder
"Too many patients were regaining weight after gastric sleeve and bypass surgery, only to be told their next option was another surgery. I believed there had to be a better way. After a decade of research at Harvard, we developed a non-surgical approach to revision. Today, Everself brings that protocol directly to patients."
Leading physicians trained and qualified by the inventor.
Dr. Pichamol Jirapinyo
Co-founder · Harvard faculty
Dr. Christopher McGowan
Charlotte · 5,000+ ESG cases
Dr. Janese Laster-Butler
Washington, DC · 4x board-certified
Dr. Brian Lim
Orange County · UC Riverside
Dr. Ali Abbas
Tampa · Harvard-trained
Dr. Avik Sarkar
New Jersey · 2x board-certified
Dr. Haroon Shahid
New Jersey · Jefferson-trained
Dr. Lindsey Merritt
Jacksonville · Borland Groover
Dr. Zaid Rana
Miami · Director of Endoscopy
Dr. Zachary Callahan
Nashville · Jefferson-trained surgeon
Dr. Julien Fahed
Houston · advanced endoscopist
Dr. Mustafa Huseini
Detroit · Brigham-Harvard fellow
Dr. Daniel Szvarca
Charleston · Hopkins & Harvard
Dr. Shehriyar Mehershahi
Dallas · interventional GI
The Everself Program
12 months of concierge care, designed around you.
The success of a gastric sleeve or gastric bypass revision depends on both what happens in the procedure room and the months that follow. Our 12-month program is built around the full arc. Most clinics manage 1–6 check-ins for the year; we map 12+ to the recovery curve.
Here for you
Nurse practitioner
Registered dietitian
Nurse care manager
Patient coordinator
"The staff is incredible to say the least and they really do demonstrate their care for their clients."
Phase 1 Month 1
Recover and heal
Two to three days of rest and gentle return to normal, then a full first month with your dedicated nurse care manager checking in daily and an Everself provider one tap away around the clock.
24/7 provider on call IV hydration therapy Dedicated nurse care manager
Phase 2 Months 2–8
Rewire nutrition and habits
1 on 1 coaching from a personal dietitian, weekly group sessions, and (if you want it) an optional GLP-1 add-on to amplify results in the first year.
Personal dietitian Group support GLP-1 add-on (optional)
Phase 3 Months 9–12
Lock in the loss
Fine-tune your weight loss and graduate into a lifetime patient community. Final provider check-ins make sure you're on track for years, not months.
Personal dietitian Fine-tune weight loss Lifetime community Final check-ins
What patients say
4.8 stars on Trustpilot. And a thousand reasons why.
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I had the revision procedure four months ago, a simple 45 minute endoscopic procedure with minimal down time, and have already lost 20% of my body weight.
Christina Verified Everself patient · Bypass revision -
I feel empowered, supported, and excited for what lies ahead. I'm embracing a healthier lifestyle and, thanks to Everself, I know this time it's going to stick.
Clint Verified Everself patient · Sleeve revision -
I've lost an incredible 45 lbs and 25 inches, and I feel amazing. The entire team has been fantastic.
Erin Verified Everself patient · Sleeve revision
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Before 
Christina lost 100 pounds
with Everself TORe -
Before 
Mindi lost 53 pounds
with Everself SIS -
Before 
Michelle lost 62 pounds
with Everself TORe -
Before 
Erin lost 45 pounds
with Everself SIS -
Before 
Jackie lost 51 pounds
with Everself TORe -
Before 
Clint lost 38 pounds
with Everself SIS
Compare your options
How endoscopic revision compares.
| Everself SIS / TORe | Revisional surgery | GLP-1 Medications | |
|---|---|---|---|
| Approach | Endoscopic — through the mouth, no incisions | Open or laparoscopic — incisions, sutures, hospital stay | Weekly self-injection, ongoing |
| Average weight loss | ~10–15% | ~15–25%, depending on procedure | ~7–15% while on treatment |
| Long-term result | Sustained with the 12-month program | Durable with lifestyle support | Returns after stopping |
| Recovery | 1–3 days off work | 2–4 weeks off work | No procedure, but lifelong medication |
| Anesthesia | Outpatient sedation | General anesthesia + hospital admission | None |
Not sure what kind of surgery you had?
You're not alone — many patients had surgery a decade or more ago and don't remember the details. Book a consultation and our team will review your operative records with you.
FAQ
Questions, answered
Am I a candidate for revision if I had bariatric surgery years ago?
Most patients are candidates regardless of how long ago they had their original bariatric surgery. The most important factors are your original anatomy, current weight, and overall health. Patients with sleeves or bypasses done 5, 10, even 20+ years ago routinely qualify for endoscopic revision. A consultation confirms eligibility.
I'm not sure whether I had a sleeve or a bypass — what should I do?
Book a consultation. Our team will review your operative records and confirm which procedure you had, then walk you through which endoscopic revision option is right for you: SIS (Sleeve-in-Sleeve) for post-sleeve patients, or TORe (Transoral Outlet Reduction) for post-bypass patients.
What's the difference between SIS and TORe?
SIS (Sleeve-in-Sleeve) is the endoscopic revision for patients who had a previous gastric sleeve gastrectomy — it re-tightens the stretched sleeve pouch by placing internal sutures along its length. TORe (Transoral Outlet Reduction) is the endoscopic revision for patients who had a previous gastric bypass (Roux-en-Y) — it narrows the dilated gastrojejunal outlet that's letting food pass through too quickly. Both procedures use the same endoscopic suturing platform; the indication and target anatomy are what differ.
How common is weight regain after bariatric surgery?
Weight regain is more common than most patients are told. Roughly 30–50% of gastric sleeve patients regain a meaningful portion of their lost weight within 5 to 10 years, typically because the surgical sleeve pouch stretches over time. About 1 in 5 gastric bypass patients regain weight within 5 years and a higher proportion at 10–20 years, usually because the gastrojejunal outlet dilates. Endoscopic revision (SIS or TORe) addresses both mechanisms without re-cutting anything.
How does endoscopic bariatric revision compare to surgical revision?
Surgical revision permanently re-cuts and re-sutures stomach or intestinal anatomy through laparoscopic incisions and typically requires 2–4 weeks of recovery. SIS and TORe place internal sutures endoscopically through the mouth — no incisions, no scars, and 1–3 days of typical recovery. Published meta-analyses put endoscopic revision's major complication rate near 1–2%, vs. about 29% for surgical revision.
How long does the endoscopic revision procedure take?
Both SIS and TORe take about 30–45 minutes. You should plan on spending roughly half a day with us, including preparation and recovery, and you'll go home the same day. No incisions, no hospital stay.
How much weight will I lose with endoscopic bariatric revision?
Sleeve revision (SIS) patients average about 15% total body weight loss; 82% lose at least 10% of their body weight. Bypass revision (TORe) patients average about 10% TBWL with the standard procedure and about 15% with TORe+ (which pairs the outlet reduction with mucosal ablation). Outcomes are strongest for patients who complete the full 12-month Everself support program.
What is recovery like after endoscopic bariatric revision?
You go home the same day. Everself provides complimentary IV hydration the day after your procedure to help you recover faster. Most patients take 1–3 days off before returning to work, following a full-liquid plan, then a soft diet (oatmeal, bananas), then regular eating over the first 2–3 weeks.
What are the risks of SIS and TORe?
Most patients experience temporary discomfort, nausea, chest pressure, or muscle spasms in the first 24–48 hours. The major complication rate — including infection, bleeding, or perforation — is around 1–2% in published series for both procedures. By comparison, the major complication rate for surgical bariatric revision is about 29%. Everself provides 24/7 clinical on-call support during the recovery period.
Will I need another revision in the future?
Endoscopic revisions can be repeated if needed — unlike surgical revisions, which become progressively riskier with each round. Most patients don't need a repeat: the 12-month Everself support program is designed to address the eating patterns that caused the original surgery to lose effectiveness. If a touch-up is ever needed, your physician can re-tighten the sutures endoscopically with the same recovery profile.
I had a lap-band or duodenal switch. Can Everself help?
Endoscopic revision is most established for post-sleeve (SIS) and post-bypass (TORe) patients. If you had a lap-band, duodenal switch, or another bariatric procedure, book a consultation and we'll walk through your specific options honestly — including whether endoscopic revision can be paired with adjuvant therapy.
What if I'm on a GLP-1 medication?
Many revision candidates come to us during or after GLP-1 treatment with Ozempic, Wegovy, or compounded semaglutide. Your Everself physician will walk through your specific situation at consultation, including how to time the transition. GLP-1 medication management is included in your revision package at no extra charge (medications themselves are not included in the package price).
Does insurance cover endoscopic bariatric revision?
Everself is a self-pay program. Most insurance plans do not currently cover endoscopic bariatric revision (SIS or TORe). Financing is available from $275/month via Cherry and CareCredit.
Restart your success — without another surgery.
A 2-minute eligibility check. No commitment.
Find my revision option