For many years, women facing mastectomy had limited options regarding immediate breast reconstruction: implants, complex flap procedures, or living without reconstruction altogether. The SWIM mastectomy, which stands for skin-sparing, wise pattern, internal mammary perforator, changed that. This approach combines cancer treatment and natural breast reconstruction into a single, streamlined procedure, offering patients from the Greater Los Angeles area, Orange County, and Ventura County a genuinely different path forward.
Bedford Breast Center’s Dr. Lisa Cassileth, one of the leading breast reconstruction surgeons in Los Angeles, developed the SWIM technique. Similar to the Goldilocks mastectomy, which was co-created by Dr. Heather Richardson, this implant-free breast reconstruction procedure preserves healthy tissue, reshapes the breast naturally, and preserves the nipple. It has opened new possibilities for patients who previously had few good options, particularly those with larger breasts.
What Is SWIM Mastectomy and Reconstruction?
The SWIM technique is a form of oncoplastic surgery that marries cancer removal with plastic surgery principles to produce a beautifully shaped reconstructed breast, all in one operation.
Meet The Brains Behind The Goldilocks Mastectomy and SWIM Breast Reconstruction
Meet The Brains Behind The Goldilocks Mastectomy and SWIM Breast Reconstruction
To learn more about the SWIM technique for breast reconstruction, please visit pubmed.gov.
The SWIM Technique vs. Traditional Mastectomy and Breast Reconstruction
The SWIM flap procedure can be performed on one or both breasts and offers meaningful advantages over conventional approaches:
No Implants or Artificial Devices: SWIM flap reconstruction relies entirely on your own breast skin and remaining tissue rather than implant reconstruction. The result is a breast that looks and feels authentically natural.
A Single Surgical Procedure: The entire process, cancer removal and reshaping, is completed in one operation. There is no need to stage multiple surgeries or endure repeated recoveries.
Better Cosmetic Outcomes: By preserving the breast skin envelope and working with the body’s own anatomy, the SWIM flap breast reconstruction technique produces results that more closely resemble breast reduction surgery than a standard mastectomy. In most cases, the nipple is preserved, and because no tissue is borrowed from the back or abdomen, there are no additional scars elsewhere on the body.
Shorter, More Comfortable Recovery: Compared to traditional reconstruction using tissue expanders and implants, patients typically return to their daily routines more quickly and with less discomfort.
Expanded Candidacy: For women who are not good candidates for implant reconstruction due to health factors, radiation history, or body type, the SWIM procedure offers a viable and attractive alternative.
The SWIM technique can also be performed as a prophylactic mastectomy. Depending on each patient’s breast cancer status, many do not require radiation therapy or routine screening mammograms following the procedure.
Unparalleled Expertise With a Compassionate Touch
Dr. Richardson and Dr. Memsic are two of the top breast surgeons in Los Angeles, using innovative techniques to create excellent clinical and aesthetic outcomes.
The SWIM procedure is particularly well-suited to women with larger or sagging breasts who want a natural-looking outcome without breast implants or lengthy recoveries. It is also an excellent option for patients who want to avoid the excess skin and contour irregularities that can follow a skin-sparing mastectomy performed without reconstruction. Women who may not qualify for traditional reconstruction due to weight, prior radiation injury, or other health considerations may also find the SWIM approach to be the right fit.
How Is SWIM Mastectomy and Reconstruction Performed?
The procedure unfolds in two integrated stages. First, the mastectomy removes cancerous or at-risk breast tissue while carefully preserving the breast skin and the underlying fat layer. In the second stage, the surgeon reshapes the remaining breast skin and healthy tissue into a new, natural breast mound. No muscle is cut or removed, and no tissue is harvested from another part of the body. The final result is a smaller, naturally shaped breast with scarring similar to what you would see after breast reduction surgery.
“I have had breast cancer twice and I can honestly say I wouldn’t have been able to get through it without the support of the whole staff at the Bedford Breast Center. The first doctor I spoke to after my first diagnosis was Dr. Memsic and she completely calmed me down. She is not only a great surgeon, but an amazing human being. I also had Dr. Cassileth as one of my plastic surgeons. Her attention to detail and perfectionism are outstanding. Any time someone comes to me asking for referrals, I send them to the Bedford Breast Center. The office is clean and warm and the staff are fantastic.”
Stacey R. – Google
What Is Recovery Like?
Recovery is individualized and depends on the specifics of each patient’s procedure. We recommend staying at an aftercare facility for one to two nights following surgery, and our nursing team remains in close contact throughout your healing process.
In the early weeks, some discomfort and bruising are normal and can be managed with prescribed medication. Compression garments help minimize swelling and support the reconstructed breast as it settles. Most patients are back to light daily activities within one to two weeks and return to work and gentle exercise shortly after. Heavy lifting should be avoided for approximately six weeks.
Goldilocks Mastectomy with SWIM Flap Breast Reconstruction Featured Before & After Photos
Case: 1 of 4
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
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
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
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
Keep in mind that each patient is unique and your results may vary.
SWIM Breast Reconstruction FAQs
Who developed the SWIM mastectomy technique?
The SWIM technique was developed by Dr. Lisa Cassileth, one of the leading breast reconstruction surgeons in the Los Angeles area at Bedford Breast Center. Her innovative approach has transformed breast reconstruction by preserving healthy tissue and creating smaller, natural-looking breasts without implants.
Is SWIM breast reconstruction available at most hospitals, or is it a specialized procedure?
SWIM is a highly specialized technique and is not widely available at most hospitals. It requires advanced expertise in both oncologic and reconstructive breast surgery. At Bedford Breast Center, patients have access to this innovative approach within a comprehensive breast care environment.
Can the SWIM technique be performed on both breasts at the same time?
In many cases, SWIM mastectomy and reconstruction can be performed on both breasts during the same surgical session. This can be appropriate for patients undergoing bilateral mastectomy for cancer treatment or risk reduction, depending on their medical situation and goals.
Will I still have nipples after SWIM mastectomy and reconstruction?
In select patients, nipple-sparing techniques may be possible. Eligibility depends on tumor location, breast anatomy, and overall cancer safety considerations. Your surgeon will determine whether preserving the nipple-areolar complex is appropriate in your case.
Does SWIM breast reconstruction leave visible scars?
SWIM is designed to minimize visible scarring while reshaping the breast into a smaller, natural contour. Incisions are strategically placed and carefully closed to support optimal healing and aesthetic outcomes.
Am I a candidate for SWIM reconstruction if I have small breasts?
SWIM is particularly beneficial for women with larger breasts who desire a smaller, lifted appearance after mastectomy. However, candidacy depends on individual anatomy and treatment goals. A consultation will determine whether this technique is the right option for you.
How long does SWIM mastectomy and reconstruction surgery take?
The procedure typically takes several hours, depending on whether one or both breasts are treated and the complexity of the case. Because reconstruction is performed at the same time as mastectomy, patients avoid multiple staged implant surgeries.
Do I need radiation therapy after a SWIM mastectomy?
The need for radiation therapy depends on cancer stage and pathology findings, not the reconstruction technique itself. Your multidisciplinary team will review your case to determine whether radiation is recommended.
Will I need follow-up mammograms after the SWIM procedure?
After a mastectomy, routine mammograms of the reconstructed breast are usually not required because most breast tissue has been removed. However, ongoing clinical exams and imaging of any remaining tissue may be recommended as part of long-term follow-up care.
Does insurance cover SWIM breast reconstruction?
Breast reconstruction following mastectomy is typically covered by insurance under federal law. Because SWIM reconstruction is performed as part of cancer treatment, it is generally covered. The Bedford Breast Center team assists patients in navigating insurance details to ensure access to this advanced reconstructive option.
The breast surgeons at Bedford Breast Center in Beverly Hills are innovative physicians who provide compassionate, personalized patient care. Our world-class facility serves patients from Los Angeles throughout Los Angeles, Southern California, and nationwide. To learn more about our center and if SWIM mastectomy and reconstruction is a good option for you, call us at
(310) 278-8590 or contact us using the online form to schedule an appointment.
Curious if your procedure is covered by insurance? Bedford Breast Center has partnered with a specialized billing service to help you maximize your insurance benefits. Click here to take a short quiz and find out if you qualify.
