In each edition, Modern Aesthetics® asks top cosmetic physicians about the newest devices in their practices. In this issue, Ran Y. Stark, MD, Plastic Surgery Associate at Bucky Plastic Surgery in Philadelphia, shares his experience with the Obalon Balloon System for weight loss. He is among the first plastic surgeons to offer this device to patients and provides valuable counsel on how to incorporate it into a plastic surgery practice.

What is The Obalon Balloon System?

Dr. Stark: The Obalon Balloon System is a new FDA-approved, non-surgical technology that is ideal for patients seeking to lose approximately 20-50 pounds. It offers a convenient and effective way to jump-start and continue significant weight loss with lasting results. The treatment plan itself consists of three lightweight balloons that are ingested as capsules and then expand over the course of six months, working to facilitate weight loss by taking up space within the stomach. Patients naturally, without feeling deprived, become fuller more quickly and eat less.

What makes it different than other devices in this category?

Dr. Stark: The Obalon Balloon represents the next generation of significant non-surgical weight loss options for men and women alike. The system is intended to be an adjunct to a healthy diet and exercise regimen for those who haven't found success through these efforts alone. Obalon makes great strides in the convenience and comfort of non-surgical weight loss because it eliminates the need for sedation or anesthesia, which was previously required in similar devices. The buoyancy of the Obalon balloons allows them to float at the top of a patient's stomach, so they do not feel the heaviness that often leads to nausea with other balloons. These gas-filled balloons are each about the size of an orange and weigh about as much as a penny.

Who is the ideal patient?

Dr. Stark: Adult men and women over the age of 22 are candidates for the Obalon Balloon System if they are on average 20-50 pounds overweight, with a body mass index (BMI) of approximately 30-40. Typically, the ideal Obalon patient is someone who has been actively attempting to lose weight through diet and exercise to no avail and isn't eligible for or wanting to take more drastic surgical measures. We've seen the most success with patients who are committed to maintaining an overall healthy lifestyle during and after treatment—many of whom elect to have body contouring procedures like a tummy tuck or breast lift to help smooth and sculpt their new physique.

Is there a treatment protocol?

Dr. Stark: In regard to balloon placement, Obalon balloons are placed approximately every two months. Beyond balloon placement, a comprehensive approach to fitness, nutrition and exercise is implemented from the very first balloon ingestion with the intent to continue after they are all removed. This combined treatment plan is key in enabling patients to be able to achieve and maintain their weight loss goals.

Any downtime/risks associated with the System?

Dr. Stark: Placement of the Obalon Balloon System typically takes less than 10 minutes and does not render any downtime because sedation isn't needed.

How are your patients responding?

Dr. Stark: We've seen tremendous success with our Obalon patients. Those who followed the treatment plan, including our proposed diet and exercise regimens, both during and post-balloons, lost and kept off their weight loss even at one year after treatment. Patients love the ease of procedure and the results they're seeing that couldn't be achieved otherwise.

Any tips on how to market this technology to patients?

Dr. Stark: The patient results speak for themselves and having our patients communicate about the experience publicly to others has been the best testimony. Introducing Obalon into a plastic surgeon's office offers a unique opportunity when compared to a bariatric surgeon's practice. The patients and their mentalities are different, and communication and marketing techniques should be reflective of these differences. There is also an added benefit of having Obalon in a plastic surgeon's office, because we are able to proliferate the self-improvement process with a unique perspective on weight loss and added expertise on body contouring and shaping.


The FDA issued an update to a health alert from February 2017 telling doctors that five people who received liquid-filled intragastric balloons died unexpectedly from 2016 until August 2017. The cause of death was unclear, but all deaths occurred within a month of balloon placement.

The FDA notes that three of the cases resulted in death within one to three days of balloon insertion, four involved the Orbera Intragastric Balloon System from Apollo Endo Surgery, and one involved the ReShape Integrated Dual Balloon System by ReShape Medical. Both devices are FDA approved for weight loss. The FDA continues to work with Apollo Endo-Surgery and ReShape Medical Inc. to better understand the issue of unanticipated death, and to monitor the potential complications of acute pancreatitis and spontaneous over-inflation.