I really think it depends on how much fat you have internally clinging onto and around your stomach. As you loose weight and body fat, the first fat you'll loose is that fat hanging onto your stomach. That's why we need a fill so soon. I've never heard that men require less fills than females. I really think thats BS. Everyone is different, why Dr. Ortiz picks one size band versus another is why he's the surgeon and I'm not. There could be numerous reasons why I got a 4cc band versus another patient got a 10cc band. I was banded almost 3 years ago, band criteria has changed since I was banded. Maybe the 4cc band is no longer available, I don't know. Like I said, bigger bands are being used in the states, maybe it's for many reasons? One, to eliminate the restriction right after surgery. The other is that in the USA, your lap band surgeon can ding the insurance company a few more times before you achive restriction. Also, there's always the possibility the 4cc band is no longer the best choice to use and its being phased out? I can't speak for your surgeon. I can't say why a surgeon uses one band or another. Plus, things change over time, some to the good and some are questionable. Since I was banded using the bigger band might be the best thing for patients. Lap band surgeons and Inamed have learned alot since I was banded and maybe the 4cc band isn't the best choice anymore. I know that every clinic that specializes in banding, they want you, as a patient, to be successful. They all live on their reputation and want you to succeed. Patients that succeed tell their friends and others that the band works. I know in the area I live in, the surgeons slowly bring a patient to restriction when they could do it the first time they adjust a patients band via using a fluoroscope and a barium swallow. Why they do blind fills and spoon feed the saline to the patients band is my theory of milking the insurance company for more money. I guess we'll have to see what Dr. Ortiz has to say about this. But, I love this kind of debate, this is why this forum and many others are on the web, to bring questions like this to the front and have a nice friendly debate,, OH I JUST LOVE THIS KIND OF DEBATE!!!