Case #1387 · Los Angeles, CA
SWIM Flap Reconstruction
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This 59-year-old patient was a BRCA1 gene carrier which indicated a predisposition for developing breast cancer. She wanted to eliminate potential risks for developing breast cancer in the future but did not want breast implants. She had a nipple-sparing Goldilocks mastectomy with SWIM Breast Reconstruction.
Continued care
Recommended aftercare, skincare, and MedSpa services for SWIM Flap Reconstruction.
- Lymphatic drainage massage starting week 2
- Compression garment for 6–8 weeks
- Scar management protocol
- Gentle range-of-motion exercises
- Hyperbaric Oxygen Therapy to support healing when recommended
- SkinCeuticals Advanced Scar Control
- Medical-grade silicone sheeting
- SPF 50+ sun protection
- LED light therapy for healing
- Laser or microneedling for scar refinement after 3 months
- Coordination
Genetic counseling coordination through the wellness team if not already in place.
BRCA+ patients benefit from coordinated long-term risk planning.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Nicotine in any form, cigarettes, vapes, patches, gum, paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- No overhead clothing for 3 weeks. Stock front-zip tops, supportive sports bras (post-clearance), and the drain pouches we provide.
- Confirm a driver for surgery day and a companion who can stay through the first night.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Rest, hydration, and short ambulation. Most patients are off prescription pain medication by day 4.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
“With SWIM reconstruction, we use the patient's own healthy tissue to create a natural, implant-free breast. For many women, knowing their result is entirely their own body is deeply meaningful.”
Dr. Lisa Cassileth
