WEIGHT LOSS SURGERY

Endoscopic Sleeve Gastroplasty South Africa

Redefining Stomach Capacity, Appetite & Lasting Weight Loss

The Art of Non-Surgical Stomach Reduction & Permanent Metabolic Transformation

AT A GLANCE
Duration: 60 – 90 Minutes
Anaesthesia: General Anaesthesia
Stay: 1 Night
Social Downtime: 3 – 5 Days

Endoscopic Sleeve Gastroplasty South Africa

Permanent Stomach Reduction &
Lasting Metabolic Transformation

A common misconception about endoscopic procedures is that they are simply a lighter version of surgery. At Vivari, we understand that the Endoscopic Sleeve Gastroplasty is a genuinely transformative medical intervention — permanently reducing the stomach’s capacity by up to 70% through a series of precisely placed internal sutures, delivered entirely through the mouth using an endoscope. No incisions. No scars. No permanent alteration visible from the outside. Our Specialist ESG program in South Africa combines this powerful stomach reduction with comprehensive nutritional guidance and lifestyle support — delivering a medically structured, behaviourally reinforced, and permanently transformative weight loss journey for patients ready to make their most committed step toward lasting health.

Exclusively at Vivari Aesthetics — South Africa’s premier destination for endoscopic sleeve gastroplasty and
luxury medically guided weight loss transformation.

Vivari Hotel Suite Room

01 | THE VIVARI EXPERIENCE

Recovery as an Art Form

Surgery is only the first step; restoration is the journey. At Vivari, we have transformed post-operative care into a curated experience. Your recovery is supported by a multidisciplinary team within our luxury clinical suites, ensuring that the days following your procedure are as serene as they are scientifically optimized.

24/7 Concierge Nursing

Expert medical care delivered within the privacy of your luxury suite.

Hyperbaric Oxygen Therapy

Accelerating cellular repair and significantly reducing post-operative swelling.

Intravenous Nutrition

Bespoke IV infusions designed to support the immune system and skin maturation.

Lymphatic Integration

Specialized post-surgical treatments at the Vivari Spa to refine your results.

02 | THE MEDICAL OVERVIEW

The Endoscopic Sleeve Gastroplasty

A masterful non-surgical stomach reduction — permanently reshaping gastric capacity for lasting, medically guided weight loss.

The Vivari Specialist Endoscopic Sleeve Gastroplasty in South Africa is a profound departure from both traditional bariatric surgery and temporary balloon interventions. While surgical sleeve gastrectomy removes a portion of the stomach through abdominal incisions, and the gastric balloon provides temporary appetite reduction, the ESG achieves a permanent structural reduction of the stomach through a series of precisely placed internal sutures — delivered entirely through the mouth using an endoscope, with no abdominal incisions and no visible scarring.

By placing approximately twelve internal sutures that reshape the stomach into a narrow, sleeve-like tube, we permanently reduce gastric capacity by up to 70% — limiting caloric intake, accelerating satiety, and fundamentally recalibrating the body’s relationship with food. Because the stomach is structurally reshaped rather than temporarily occupied, the results of our ESG program in Johannesburg are more enduring than a gastric balloon — delivering a permanent foundation for sustained, medically supervised weight loss.

The Strategic Advantages

💎 Permanent Structural Reduction: By surgically reshaping the stomach through internal suturing rather than external incisions, the ESG delivers a lasting reduction in gastric capacity — providing a permanent structural foundation for weight loss that the gastric balloon simply cannot replicate.

⚖️ No Incisions, No Scars: Unlike traditional sleeve gastrectomy which requires multiple abdominal incisions, the ESG is performed entirely through the mouth using an endoscope — leaving no visible external scars and significantly reducing the risks associated with open or laparoscopic surgery.

👁️ Reversible & Convertible: Although designed as a permanent procedure, the ESG can be reversed or converted to other forms of weight loss surgery if clinically indicated — offering a degree of flexibility that traditional bariatric surgery does not provide.

◎ Comprehensive Medical Support: Every ESG patient at Vivari benefits from personalised nutritional guidance, lifestyle coaching, and continuous medical monitoring throughout the complete treatment and maintenance period — ensuring your weight loss journey is comprehensively supported for lasting success.

Clinical Focus

Gastric Reshaping: Approximately twelve precisely placed internal sutures reshape the stomach into a narrow, sleeve-like tube — reducing its capacity by up to 70% and limiting the volume of food that can be comfortably consumed at any one time.

Satiety Recalibration: The dramatically reduced stomach volume creates a consistent, powerful feeling of fullness after significantly smaller food portions — naturally reducing caloric intake without requiring willpower or restrictive dieting alone.

Behavioural Transformation: Our comprehensive nutritional and lifestyle support program runs concurrently with the ESG treatment — embedding the sustainable dietary habits and lifestyle changes that maximise weight loss results and ensure long-term maintenance.

Medical Monitoring: Regular clinical reviews throughout the post-procedure period monitor weight loss progress, nutritional status, and overall health — adjusting the support program as needed to ensure the safest and most effective long-term outcome.

03 | THE JOURNEY

Your Path to Vivari

From first consultation to lasting transformation, every step is designed with precision and care.

01 THE CONSULTATION

Your transformation begins with a comprehensive medical assessment evaluating your BMI, gastrointestinal health, weight loss history, and lifestyle factors. We determine your suitability for the ESG program and design a bespoke treatment plan — combining the endoscopic stomach reduction with a personalised nutritional and lifestyle support program tailored entirely to your individual weight loss goals and long-term health aspirations.

02 THE PREPARATION

In the days leading to your procedure, we focus on clinical optimisation. This includes a tailored medical review, pre-procedure dietary protocol, and medication assessment — ensuring you are fully prepared for a safe, comfortable endoscopic procedure and the most effective possible start to your permanently transformed relationship with food and health.

03 THE PROCEDURE

Performed under general anaesthesia for complete comfort. Your specialist gently passes a flexible endoscope through the mouth into the stomach — placing approximately twelve precise internal sutures that reshape the stomach into a narrow, sleeve-like tube. The complete procedure takes 60 to 90 minutes, with most patients returning home the following day.

04 THE RECOVERY

Following your procedure, mild nausea and discomfort are normal for the first few days. Our clinical team provides comprehensive dietary progression guidance, 24-hour support, and regular follow-up reviews — guiding you through every phase of your ESG weight loss journey with expert, compassionate care.

04 | CLINICAL CLARITY

For a comprehensive understanding of our clinical protocols, please explore the details below.

MEDICAL HISTORY AND EXAM Prepare to answer questions about your complete medical history, including previous weight loss attempts, current medications, history of gastrointestinal conditions, previous stomach surgery, hiatal hernia, diabetes, hypertension, and any other obesity-related health conditions. Your specialist will evaluate your BMI, overall gastrointestinal health, and weight loss goals. A comprehensive physical exam — conducted alongside relevant blood work, endoscopic assessment, and clinical evaluations — ensures your suitability for the ESG program in South Africa and confirms the most appropriate treatment and support plan for your individual journey.

MEDICATION REVIEW A strict review of all prescriptions and supplements is required to ensure safety throughout the ESG procedure and recovery period. Certain medications — particularly blood thinners, anti-inflammatory drugs, and those affecting the gastrointestinal system — must be adjusted prior to the procedure. Your specialist will provide clear, personalised guidance on all medication management throughout your endoscopic sleeve gastroplasty program.

WEIGHT LOSS HISTORY & LIFESTYLE ASSESSMENT We conduct a comprehensive review of your previous weight loss attempts, dietary patterns, lifestyle habits, and relationship with food. By understanding exactly where previous approaches have fallen short, we design a bespoke nutritional and lifestyle support program that addresses the specific behavioural and physiological factors unique to your individual weight loss journey — maximising the transformative potential of your ESG procedure.

ESTABLISHING EXPECTATIONS We discuss how the Specialist ESG achieves permanent stomach reduction through internal suturing — setting realistic expectations around the degree of weight loss achievable, the critical importance of dietary compliance during the post-procedure recovery period, and the personalised long-term maintenance plan that sustains your results for years following the procedure.

FOLLOW MEDICATION DIRECTIONS You will receive specific instructions on which medications to pause or adjust prior to your procedure. Blood-thinning supplements and anti-inflammatory drugs must typically be discontinued well in advance — your specialist will provide a personalised medication management plan to ensure safe endoscopic stomach reduction and optimal post-procedure healing.

PRE-PROCEDURE DIETARY PROTOCOL Patients are provided with a specific pre-procedure dietary protocol — typically a liquid or soft diet in the days leading to the ESG — to ensure the stomach is appropriately prepared for endoscopic suturing. Strict adherence to this protocol is essential for both procedural safety and the best possible outcome.

FASTING PROTOCOLS To ensure a safe general anaesthesia experience, do not eat or drink anything for a minimum of six hours before your procedure. Clear water and approved medications are permitted only as specifically directed by your clinical team to prepare for your anaesthesia protocol.

VIVARI PRE-PROCEDURE BUNDLE Specific nutritional supplements and health optimisation protocols are initiated in the weeks prior to your ESG procedure. These are designed to optimise your metabolic health, nutritional status, and gastrointestinal readiness — ensuring your body is fully prepared to maximise the weight loss results of the ESG program from day one.

LIFESTYLE PREPARATION To maximise the long-term success of your ESG program, we encourage patients to begin engaging with our nutritional guidance and lifestyle coaching resources before the procedure. Building awareness of healthy eating patterns, portion control, and behavioural change strategies in advance significantly enhances the permanent transformation the ESG facilitates.

ARRANGE FOR RECOVERY SUPPORT The ESG requires general anaesthesia and an overnight hospital stay. You must arrange for a responsible adult to collect you upon discharge — and we recommend having support available at home for the first three to five days as your body adjusts to the reduced stomach capacity and dietary progression protocol.

ANAESTHESIA General anaesthesia is administered to ensure you are completely comfortable and unaware throughout the complete ESG procedure. Unlike the gastric balloon which requires only mild sedation, the ESG’s precision suturing demands the stillness and safety of full general anaesthesia for optimal procedural accuracy and patient comfort.

ENDOSCOPIC ACCESS A thin, flexible endoscope equipped with a specialised suturing device is gently passed through the mouth and into the stomach. The tiny camera allows your specialist to visualise the complete interior of the stomach with precision — guiding the suturing process without any abdominal incisions or external scarring.

PRECISION INTERNAL SUTURING Approximately twelve precisely placed internal sutures are applied along the greater curvature of the stomach — folding and reshaping it into a narrow, sleeve-like tube. This permanently reduces gastric capacity by up to 70%, limiting food volume, accelerating satiety, and fundamentally recalibrating the stomach’s functional architecture.

RECOVERY & DIETARY PROGRESSION Following the procedure, a carefully structured liquid-to-solid dietary progression protocol guides your stomach through the critical initial healing period — ensuring the sutures integrate optimally and the reduced stomach adapts safely to its new structural architecture before solid foods are reintroduced.

IMMEDIATE AFTERCARE You will spend one night in our luxury clinical suite following your ESG procedure — monitored by our 24-hour nursing team as the anaesthesia clears and your body begins adjusting to the reduced stomach capacity. Mild nausea and abdominal discomfort are normal for the first two to five days and are managed with prescribed medication and our structured dietary progression protocol.


CRITICAL RECOVERY GUIDELINES

  • Avoid: Solid foods for the first two weeks — follow the liquid-to-soft dietary progression protocol provided by your clinical team precisely.
  • Action: Stay well hydrated, take all prescribed medications as directed, rest adequately, and attend all scheduled follow-up reviews to ensure optimal suture integration and weight loss progress.

WHEN TO CONTACT YOUR SURGEON
Contact the clinic immediately if you experience:

  • Severe, persistent vomiting or abdominal pain beyond five days.
  • Any signs of gastrointestinal bleeding or unusual discharge.
  • Fever or signs of infection following the procedure.

FOLLOW-UP SCHEDULE

  • INITIAL RECOVERY (WEEKS 1–2) Daily dietary progression from liquids to soft foods, guided by your clinical dietitian. Regular clinical check-ins ensure your comfort, safety, and dietary compliance during the critical initial suture integration period.
  • ACTIVE WEIGHT LOSS PHASE (MONTHS 1–6) Monthly clinical reviews monitor weight loss progress, nutritional status, and overall health. Your nutritional and lifestyle support program is continuously adjusted to ensure optimal, sustained results throughout the active weight loss period.
  • LONG-TERM MAINTENANCE (12+ MONTHS) A structured long-term maintenance program monitors your weight management, nutritional health, and overall wellbeing — ensuring the permanent structural transformation of your ESG delivers enduring, life-changing weight loss results for years to come.

FREQUENTLY ASKED QUESTIONS

An Endoscopic Sleeve Gastroplasty is a non-surgical stomach reduction procedure that permanently reshapes the stomach into a narrow, sleeve-like tube using approximately twelve precisely placed internal sutures — delivered entirely through the mouth using an endoscope. With no abdominal incisions and no visible scarring, the ESG reduces gastric capacity by up to 70% — limiting food volume, accelerating satiety, and delivering a permanent structural foundation for sustained medically guided weight loss in South Africa.

Ideal candidates for endoscopic sleeve gastroplasty in South Africa are individuals with a BMI of 30 or above who have not achieved significant weight loss through diet and exercise alone, have no history of prior stomach surgery or significant hiatal hernia, and are committed to the comprehensive nutritional and lifestyle support program. The ESG is particularly well-suited for patients seeking a more permanent, structural weight loss intervention than the gastric balloon without the recovery demands of traditional bariatric surgery.

A surgical gastric sleeve removes approximately 80% of the stomach through multiple abdominal incisions under general anaesthesia — permanently and irreversibly. The ESG achieves a comparable stomach reduction through internal suturing delivered entirely through the mouth — with no abdominal incisions, significantly reduced recovery time, and the possibility of reversal or conversion if clinically indicated. The ESG is the non-surgical, lower-risk alternative for appropriate candidates.

Performed under general anaesthesia for complete comfort, your specialist gently passes a flexible endoscope through the mouth into the stomach. Approximately twelve precise internal sutures are placed along the stomach’s greater curvature — reshaping it into a narrow, sleeve-like tube that reduces capacity by up to 70%. The complete procedure takes 60 to 90 minutes, after which you recover overnight in our luxury clinical suite before returning home the following day.

Most patients experience mild nausea and abdominal discomfort for the first two to five days — managed with prescribed medication and our structured liquid-to-soft dietary progression protocol. Social downtime is typically three to five days, with most patients returning to light activity within a week. Full dietary progression to normal foods takes approximately two to four weeks as the sutures integrate and the reduced stomach adapts to its new structural architecture.

Clinical studies report an average weight loss of 17–19kg over twelve months following ESG — with results varying based on individual adherence to the nutritional and lifestyle support program. Patients with a higher starting BMI typically achieve more significant absolute weight loss. Our comprehensive post-procedure support program is specifically designed to maximise and sustain your individual ESG weight loss results long-term.

The endoscopic sleeve gastroplasty cost in South Africa at Vivari Aesthetics starts from R85,000 — inclusive of the procedure, general anaesthesia, overnight clinical stay, comprehensive nutritional and lifestyle support program, and regular long-term clinical reviews. A definitive investment quote is provided after your initial medical consultation and assessment.

Vivari Aesthetics offers a level of medically guided, comprehensively supported gastric balloon care that goes beyond simple balloon placement. By combining clinical expertise with personalised nutritional guidance, lifestyle coaching, and continuous medical monitoring, we ensure results that are not only meaningful during the treatment period but sustained and built upon for lasting weight management success.

Vivari Aesthetics is the premier destination for endoscopic sleeve gastroplasty in Johannesburg, South Africa, combining medical precision with five-star care. Conveniently located near Lanseria International Airport, we welcome patients from across South Africa and internationally who seek permanent non-surgical weight loss, medically guided transformation, and results that are both structurally lasting and life-changing.

The Art of the Subtle Transformation

In permanent non-surgical weight loss, excellence is measured not just in kilograms lost — but in the lasting structural and behavioural transformation that sustains those results for life. The Vivari ESG approach combines permanent gastric reshaping with comprehensive nutritional and lifestyle support to achieve a result that is both meaningfully transformative and genuinely enduring. Our commitment is to a weight loss journey that delivers real, lasting change — never a temporary intervention, a superficial result, or an unsupported outcome.

A Note on Clinical Maturation: Weight loss outcomes following the ESG vary between individuals based on starting BMI, adherence to the nutritional and lifestyle support program, and individual metabolic response. Clinical studies report an average weight loss of 17–19kg over twelve months — with patients who engage fully with every dimension of the Vivari program consistently achieving the most significant and sustainably maintained transformations. We allow the complete program a full twelve months to reveal its most comprehensive and enduring result.

05 | THE ELITE CHOICE

The Celebrity Spotlight

THE ART OF SUSTAINABLE TRANSFORMATION

In Hollywood and global elite circles, the most respected weight loss transformations share one defining characteristic — they are permanent, medically guided, and comprehensively supported. The world’s most celebrated public figures have quietly moved away from unsustainable crash diets and temporary interventions toward clinically proven, structurally permanent solutions that deliver lasting results with dignity and expert care.

From Rebel Wilson’s celebrated commitment to medically guided weight loss to the growing number of global executives, entertainers, and high achievers who choose endoscopic procedures for their minimal invasiveness and maximum impact, the world’s most successful people understand that permanent weight loss requires permanent structural change — not willpower alone. The “Vivari Transformation” isn’t about a dramatic moment; it’s about the compassionate medical expertise, permanent stomach reduction, and comprehensive long-term support that transforms not just the body — but the relationship with health, food, and confidence for a lifetime.

Why the Specialist ESG is the Elite Standard:

💎 Permanent Structural Foundation: By permanently reducing the stomach’s capacity by up to 70% through precise internal suturing, the ESG delivers a lasting structural foundation for weight loss that no temporary intervention — balloon, injection, or dietary program — can replicate.

👁️ Complete Discretion: The ESG leaves no visible abdominal scars, requires no external incisions, and involves only a single overnight stay — making it the most discreet permanently transformative weight loss procedure available, entirely on your own terms.

✦ Superior to Traditional Surgery: Unlike surgical sleeve gastrectomy with its multiple abdominal incisions, extended recovery, and permanent irreversibility, the ESG achieves comparable stomach reduction with significantly lower risk, faster recovery, and the possibility of conversion if clinically needed.

◎ Comprehensively Supported: We don’t simply reshape the stomach; we deliver a complete, medically guided transformation program — combining permanent structural reduction with deep nutritional and behavioural recalibration for weight loss results that are both structurally and behaviourally enduring.

06 | THE VIVARI INVESTMENT

A Legacy of Lasting Health & Permanent Transformation

The Specialist Endoscopic Sleeve Gastroplasty at Vivari is a comprehensive medical investment in permanent structural weight loss — combining clinically proven endoscopic stomach reduction with personalised nutritional guidance, lifestyle coaching, and continuous long-term medical monitoring. For patients seeking a less permanent first step, the Intragastric Balloon offers a reversible, non-surgical weight loss alternative as a lower-commitment entry point to medically guided transformation.

To ensure the highest standard of medical focus, we require a comprehensive pre-consultation health assessment. Your diagnostic reservation fee will be credited toward your treatment program should you choose to proceed.

The Surgical Investment | From R210,000
Our transparent pricing is inclusive of the surgeon’s honorarium, expert anesthetic care (TIVA), state-of-the-art facility fees, and your initial bespoke recovery suite stay.

OVERNIGHT PACKAGES

Extend your recovery in the quiet luxury of the Vivari Hotel. Our bespoke post-operative packages include:

Curated Nutrition

Specialized menus from our restaurant designed for optimal healing.

Lymphatic Support

Gentle spa treatments to reduce swelling and accelerate recovery.

Seamless Care

24/7 access to clinical staff within a five-star hotel environment.

07 | THE VIVARI DOSSIER

Comprehensive Clinical Guide

An in-depth exploration of Endoscopic Stomach Reduction, our specialist Endoscopic Sleeve Gastroplasty protocols, and the full suite of recovery and support experiences at Vivari.

DOWNLOAD PDF BROCHURE

To ensure every patient receives the undivided attention and surgical expertise required for a bespoke transformation, we operate a refined pre-consultation process.

Your journey begins with a comprehensive clinical questionnaire. This initial diagnostic assessment allows our surgical team to review your unique facial and body architecture before your private appointment.

Initial Assessment Fee: R1,000

An additional R1,250 applies for an in-person consultation.
Should you proceed with surgery, a total of R2,250
will be credited toward your procedure.

BEGIN NOW

Consultations are held in absolute confidence.
There is no obligation to proceed.