SWIM Reconstruction vs. Goldilocks: What’s The Difference?

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What is SWIM breast reconstruction, what is a Goldilocks mastectomy, and how do they differ? I’m often asked this question since Bedford Breast Center in Beverly Hills and our sister practice, Cassileth Plastic Surgery, are known for these advanced breast cancer surgeries.

Before we delve into the difference between the two procedures, let’s establish the key similarities: both are mastectomy reconstructions that don’t use breast implants or free flaps.

History of the Goldilocks Mastectomy

The Goldilocks mastectomy was invented over ten years ago by breast surgeon, Dr. Heather Richardson. A breast cancer patient asked it if it was possible to have a closure that could use some of her extra fat and skin to create a small breast mound. She didn’t want implants, the extensive recovery of a flap procedure, or to go flat.

After Dr. Richardson completed the mastectomy, she used the classic “Wise pattern” or “anchor incision” (commonly used by plastic surgeons during breast reduction surgery) to close the breast. And just like that, she discovered this technique was a great alternative to aesthetic flat surgery.

She named the procedure Goldilocks since it was “just right” for patients who didn’t want implants or a flat closure. Consider it a “not too hot, not too cold” alternative to traditional breast reconstruction.

How Goldilocks Evolved into SWIM Breast Reconstruction

Dr. Richardson and I had a case where the patient wanted a Goldilocks mastectomy but was also a candidate for a nipple-sparing surgery. This presented us with an exciting new challenge – can we spare the nipple and still perform a “no implant” reconstruction, like the Goldilocks?

We got to work on the SWIM breast reconstruction technique; we preserved the nipple blood flow on the internal mammary perforators so that the nipple could be saved.

SWIM stands for “skin-sparing Wise pattern internal mammary” reconstruction. Like Goldilocks, we don’t use implants or flaps, but now patients could keep their nipples and have a small, natural breast. So, there you have it! The primary difference between the two procedures is that SWIM allows us to preserve the nipple; the Goldilocks does not.

Raising the Bar for Breast Cancer Surgery

Goldilocks was a breakthrough in breast cancer surgery. With the advancement of the SWIM technique, we made it an even better reconstruction option for nipple-sparing mastectomy candidates.

Both procedures were made possible because a patient advocated for herself. It’s a prime example of how our patients continuously push us to become better surgeons and set a higher standard for breast cancer treatment.

Schedule a Consultation

To learn more about Goldilocks mastectomy, SWIM breast reconstruction, and to discuss your breast cancer treatment options, call our Beverly Hills breast center at (310) 278-8590 or contact us online to request a consultation.

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