436 North Bedford Drive Ste 103,
Beverly Hills, CA 90210
Phone: (310) 278-8200
Monday – Friday: 9 a.m.–5 p.m.
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.
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Keep in mind that each patient is unique and your results may vary.
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.
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 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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SWIM mastectomy and reconstruction offers multiple advantages over traditional techniques:
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.
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.
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.
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
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.
Breast and nipple sensation after SWIM breast reconstruction varies with the location and size of the cancer. In some cases, the surgeon can perform a sensation-preserving mastectomy, which preserves the nerve root and uses nerve grafts to reconnect it to recipient nerves under the preserved areola-nipple complex.
The SWIM technique creates a breast using the healthy fat, skin, and breast tissue left behind after removing the necessary mammary tissue without the need for implants.
If you have naturally very small breasts, you are probably not a good candidate for this technique. There needs to be enough breast skin and fat after the mastectomy to form a new breast.
The incisions from SWIM breast reconstruction are similar to the anchor incision used for breast reduction. Dr. Cassileth and her post-op team work closely with patients to manage scars and minimize their appearance. Recommended treatments typically include a series of peptides, laser treatments, and detailed post-op care instructions.
Because the surgeon removes all of the mammary tissue, the risk level is low, similar to a simple mastectomy.
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.
