SWIM Breast Reconstruction

Dr. Lisa Cassileth and Dr. Heather Richardson advanced the standard of treatment beyond traditional options when they developed SWIM breast reconstruction. Patients from Greater Los Angeles and all over the world come to Real Breast Reconstruction in Beverly Hills for this remarkable procedure, which removes cancer, preserves healthy tissue, and creates beautiful, implant-free breast contours, all in a single stage.

Goldilocks Mastectomy with SWIM Flap Breast Reconstruction
Featured Before & After Photos

Case: 1 of 4
Case #20
This 47-year-old woman from Miami, FL carries the BRCA1 gene mutation and took preventative measures to reduce her risk of breast cancer. She did not want breast implants and sought out Dr. Lisa Cassileth for implant-free breast reconstruction. Dr. Heather Richardson performed a prophylactic bilateral mastectomy, and Dr. Cassileth performed S... Read More

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Before & After Goldilocks Mastectomy with SWIM Flap Breast Reconstruction Case 20 Front View in Beverly Hills, CA
Before
After
Case: 2 of 4
Case #15
From Los Angeles, CA, with a strong family history of breast cancer, this patient opted to have a prophylactic mastectomy. Wanting a natural, implant-free look, she underwent a bilateral mastectomy performed by Dr. Leslie Memsic, followed by SWIM Breast Reconstruction by Dr. Elise Min. Read More
Before & After Goldilocks Mastectomy with SWIM Flap Breast Reconstruction Case 15 Front View in Beverly Hills, CA
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After
Case: 3 of 4
Case #16
From San Diego, CA. After testing positive for BRCA gene mutation, this patient sought to undergo a prophylactic mastectomy to reduce her risk of breast cancer. She did not want to have breast implants, so she opted for Goldilocks mastectomy by Dr. Richardson and SWIM Flap breast reconstruction by Dr. Cassileth. The patient loves her smaller... Read More
Before & After Goldilocks Mastectomy with SWIM Flap Breast Reconstruction Case 16 Front View in Beverly Hills, CA
Before
After
Case: 4 of 4
Case #17
From Pacific Palisades, CA, this breast cancer patient had a Goldilocks mastectomy performed by Dr. Richardson. Dr. Cassileth then performed SWIM breast reconstruction, resulting in an implant-free breast reconstruction using the patient’s native breast tissue to create smaller, natural breasts. Read More
Before & After Goldilocks Mastectomy with SWIM Flap Breast Reconstruction Case 17 Front View in Beverly Hills, CA
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Keep in mind that each patient is unique and your results may vary.

The Essentials of SWIM Mastectomy & Reconstruction

SWIM is an acronym for skin-sparing, wise pattern, internal mammary perforator. The SWIM technique conserves the breast’s skin, fat, and nipple and employs strategic incision patterns. This integrative oncoplastic approach combines cancer removal with reconstructive plastic surgery, using preserved healthy tissues to sculpt a smaller, naturally contoured breast. Reconstruction is performed at the time of mastectomy.

Traditional Multi-Stage Methods vs. the One-Stage SWIM Technique

The traditional approach to mastectomy and reconstruction is a multi-stage process involving the complete removal of breast tissue—often resulting in considerable scarring and chest concavity.

During reconstruction, tissue expanders are placed to create space for breast implants. Over several months, these expanders are gradually filled with saline. Once the chest has healed and expanded adequately, another surgery is performed to replace the expanders with implants. Further procedures may be needed to adjust shape and size and ensure symmetry.

While these standard methods have been successful in treating and preventing the spread of breast cancer, the SWIM technique dramatically improves the patient’s experience and outcome.

Our World-Class Surgical Team
Dr. Cassileth, Dr. Killeen, Dr. Richardson, and Dr. Mesmic Dr. Cassileth, Dr. Killeen, Dr. Richardson, and Dr. Mesmic

Our surgical team stands out for their individual excellence and collective commitment to delivering patient-focused treatment. Together, they provide a synergy of expertise that translates into unsurpassed care and exceptional patient outcomes.

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The Benefits of SWIM Mastectomy & Breast Reconstruction

SWIM mastectomy and reconstruction offers multiple advantages over traditional techniques:

  • Single-Stage Surgery: The SWIM method achieves full reconstruction in just one surgical session.
  • Superior aesthetic results: The results of SWIM mastectomy and reconstruction resemble the aesthetic outcome achieved by breast reduction surgery.
  • Skin-sparing: The SWIM technique preserves the natural breast envelope, enabling a better cosmetic outcome.
  • Nipple-sparing: Preservation of the nipple and areola contributes to a natural-looking breast.
  • Improved symmetry: The surgeon sculpts the tissue to match the remaining breast.
  • Implant-free reconstruction: This method forgoes the use of implants, using your own tissues for a more natural appearance and feel. The natural tissues used in SWIM reconstruction are permanent, unlike breast implants, which have an average lifespan of about 10 to 15 years.
  • Lower risk of complications: Using your own tissue reduces the risk of complications compared to implants.
  • Enhanced comfort and faster healing: The SWIM technique enables a quicker, more comfortable recovery than traditional methods.

The SWIM technique is also an option in prophylactic mastectomy surgeries and reconstruction revision procedures. Depending on your cancer status, the procedure may eliminate the need for radiation therapy or routine mammograms post-surgery.

Ideal Candidates for SWIM Breast Reconstruction

You may be a candidate for SWIM breast reconstruction If you have larger breasts and don’t want implants or flap reconstruction using transplanted tissues. The technique can also be a suitable alternative for patients who can’t undergo conventional reconstruction because of medical, radiation-related, or weight considerations.

The SWIM Mastectomy & Reconstruction Technique Explained

SWIM mastectomy and reconstruction is a single-stage surgery comprising two phases. The first phase is the mastectomy, during which the surgeon excises breast tissue while meticulously preserving healthy tissue and skin. The second phase involves the artistic reconstruction of the breast using the preserved skin, fat, and nipple.

In cases where the nipple can’t be spared, the Goldilocks mastectomy—an advanced, tissue-sparing technique similar to the SWIM mastectomy—may be employed during the first phase.
The length of the procedure varies depending on the complexity of the reconstruction, whether the nipple is being preserved, and how much tissue is available for use. On average, the procedure takes a few hours, with adjustments made for individual patient needs.

Like any surgical procedure, SWIM reconstruction carries potential risks, which may include infection, complications with wound healing, and issues related to anesthesia. Your surgical team will provide a comprehensive risk assessment and make sure you clearly understand the potential complications before surgery.

Dr. Lisa Cassileth is an experienced and skilled surgeon at the forefront of breast cancer reconstruction.

I was diagnosed with IDC in Feb of this year and a friend referred me to her and I feel so blessed she did. There aren’t many options in the mastectomy world and Dr. Cassileth’s SWIM technique was a game changer for me.

-Melissa

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What To Anticipate During SWIM Reconstruction Recovery

You can expect some bruising and a period of manageable discomfort, controlled with prescription medication.

Most patients can return to normal daily activities and engage in light exercise within 1 to 2 weeks. However, you should avoid heavy lifting for approximately 6 weeks to ensure proper healing.

Trust Our World-Renowned Breast Reconstruction Surgeons

Our world-class facility in Beverly Hills serves breast reconstruction patients from the Greater Los Angeles area and beyond. To learn more about SWIM breast reconstruction, call us at (310) 278-8200 or  contact us  using the online form to schedule an appointment.

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