SWIM Breast Reconstruction

What Is SWIM Breast Reconstruction?

The SWIM mastectomy technique stands for skin-sparing, wise pattern, internal mammary perforator.

It is a revolutionary breast reconstruction procedure that does NOT require any breast implants or free flaps.

Expert Beverly Hills breast surgeon, Dr. Lisa Cassileth created this low-risk breast reconstruction technique inspired by Dr. Heather Richardson’s published no implant/breast mound procedure, the Goldilocks mastectomy.

History of the SWIM Breast Reconstruction Technique

This innovative breast cancer treatment option was first developed as the Goldilocks mastectomy –a breast cancer treatment option that removes unhealthy breast gland tissue while preserving healthy tissue and skin.

Co-developed by our very own Dr. Richardson, Goldilocks mastectomy leaves a patient with a smaller breast with no nipple present instead of a lack of one after a mastectomy, providing the best possible immediate outcome in a single procedure with minimal downtime. 

Dr. Cassileth and Dr. Richardson advanced the technique further, allowing the nipple to be preserved and recruit more local fat into the area. The method enables a natural-appearing breast reconstruction procedure that resembles a breast reduction.

However, the approach achieves more than a standard reduction because it serves as a complete nipple-sparing mastectomy. To learn more about the SWIM technique for breast reconstruction, please visit pubmed.gov.

What Is the Difference Between SWIM Breast Reconstruction and a Traditional Mastectomy?

The main difference between the SWIM technique and a traditional mastectomy is the approach SWIM uses to reconstruct more natural-looking breasts. The SWIM technique does not involve implants or tissue transfer techniques. Instead, the SWIM technique utilizes the remaining healthy breast tissue, leaving the patient with smaller, natural breasts and a superior cosmetic result. 

Advantages of the SWIM Technique

There are several advantages to the SWIM reconstruction technique. These include:

• May be performed on one or both breasts
• May be performed for prophylactic mastectomy 
• Does not require additional surgeries 
• Does not use implants or artificial devices
• Offers greater comfort and a shorter recovery time compared to traditional breast reconstruction
• Provides an excellent option for patients who are not ideal candidates for or do not prefer traditional breast reconstruction
• Offers additional benefits for patients with extremely large or sagging breasts 

Additionally, surgical removal of breast gland under the skin means:

• No screening mammograms required
• Depending on breast cancer status, most patients do not require radiation

Who Is a Candidate for SWIM Breast Reconstruction?

Women with large breasts who need a mastectomy often have minimal options for breast reconstruction presented to them. Doctors often recommend a tissue expander or a perforator flap procedure.

We developed the SWIM technique especially for large-breasted women who want natural-looking breasts after mastectomy. 

Any patient who prefers to avoid implant reconstruction, flap reconstruction (such as DIEP flap or TRAM flap), extensive incisions, a long recovery time, or multiple procedures does have another choice.

Many may achieve a more satisfying aesthetic result and a more comfortable experience from a SWIM technique compared to a traditional mastectomy. Since the SWIM technique does not involve as many risks as traditional reconstruction, patients who discover they are not good breast reconstruction candidates because of health issues, weight, or radiation injury may also benefit from the SWIM technique.

How Is the SWIM Technique Performed at our Medical Center?

At our Beverly Hills medical center, we perform the SWIM breast reconstruction surgery as one procedure in two stages. First, we carefully remove all breast tissue in the mastectomy portion of the procedure, preserving the skin and subcutaneous fat.

During the second stage, the reconstruction step, we fold the extra fat in stacks to create the appearance of a new breast. No muscle is cut or removed from donor sites, and no abdominal, back, or buttock tissue is transferred. The remaining skin and fat create a new, smaller breast.

If extra skin is present lateral to the breast, often called the “dog ear,” we will also use this fat under the breast before removing excess skin. The final result is a breast that appears smaller than the original, with scars similar to a breast reduction procedure.

What Is SWIM Breast Reconstruction Recovery Like?

After undergoing SWIM breast reconstruction, patients typically experience some discomfort and bruising in the chest. Patients are advised to wear compression garments during the first few weeks to help with swelling.  

Within 1 to 2 weeks, most patients are ready to return to their daily routines, including returning to work and light exercise. Heavy lifting, which includes picking up small children, can typically resume after 6 weeks.  

Each patient’s recovery timeline is unique and based on a variety of factors, so it’s crucial to follow your doctor’s postoperative instructions carefully. We recommend patients stay at an aftercare facility for the first 1 to 2 nights after surgery. Our dedicated aftercare nursing team maintains close communication with patients throughout recovery, ensuring a smooth and seamless healing process. 

Schedule a Consultation With a Beverly Hills Breast Surgeon Today

Going through a mastectomy or a breast reconstruction procedure is a challenging experience. We believe women deserve a breast cancer team who can understand women and make them feel healthy and beautiful.

If a mastectomy is your breast cancer treatment option, give us a call. Bedford Breast Center was created by women for women and offers superior mastectomy results in Beverly Hills, CA. For more information or to schedule an appointment, contact one of our medical center today.

SWIM Breast Reconstruction FAQ

Is SWIM mastectomy the best option?

The decision on whether SWIM mastectomy is the best option for breast cancer treatment depends on several factors, including the specific characteristics of the patient’s cancer, individual preferences, and the recommendations of your surgeon. SWIM mastectomy can provide a more aesthetically pleasing outcome for some patients and may be suitable for certain breast cancer cases. However, the best treatment option should be determined through a comprehensive evaluation by your health care team.

How much natural breast tissue can be saved with this technique?

The amount of natural breast tissue that can be preserved with SWIM mastectomy varies depending on factors such as the location and extent of the tumor, the size of the breast, and individual patient considerations. Your surgeon will discuss your needs and preferences with you and provide recommendations.

Is this a nipple-sparing mastectomy?

SWIM mastectomy is not specifically designed as a nipple-sparing mastectomy technique. The decision about whether the nipple and areola complex can be preserved depends on factors such as the location and extent of the tumor, the involvement of the nipple-areola complex, and individual patient considerations. Your surgeon can advise whether sparing the nipple is possible in your case.

What’s the difference between a skin-sparing mastectomy and a traditional mastectomy?

In a traditional mastectomy, the entire breast tissue is removed, including the skin envelope covering the breast. Skin-sparing mastectomy, on the other hand, preserves the breast skin envelope while removing the breast tissue. By preserving the skin envelope, skin-sparing mastectomy provides a better cosmetic outcome for breast reconstruction, as the breast can be reconstructed using implants or autologous tissue while maintaining the natural skin envelope. Your surgeon can provide personalized advice and guidance based on your specific situation.