Pioneered here
Three procedures
she invented.
Each was developed in response to a real clinical limit, published in a peer-reviewed journal, and trained out to the broader surgical field.
2007 (published 2011)
Direct-to-Implant Reconstruction
Annals of Plastic Surgery
Traditional reconstruction after mastectomy required tissue expanders, weeks of painful inflation, and a second operation to place implants. For most women, the process took six months to a year.
Reconstruct the breast at the same time as the mastectomy. One operation. No expanders. No second surgery. The technique required rethinking how the implant is supported from the outset, and proving the construct could hold.
DTI is now performed by surgeons worldwide. Dr. Cassileth's published research established the protocol used as a starting point at training programs across the country.
“Reconstructing the breasts at the same time as mastectomy eliminates the risks of multiple surgeries and, more importantly, helps minimize the sense of loss.”
Cassileth, Kohanzadeh, Amersi. "One-stage immediate breast reconstruction with implants: a new option for immediate reconstruction." Annals of Plastic Surgery, 2011.
Read about DTI
2020
SWIM Flap Reconstruction
Journal of the American College of Surgeons
For patients who wanted reconstruction without implants, traditional flap procedures often meant sacrificing major muscle, with donor-site weakness and a long recovery. Some patients were also not ideal candidates for implants because of excess skin following mastectomy.
The SWIM flap (Skin-sparing, Wise-pattern, Internal Mammary perforator) uses the patient's own local tissue to reconstruct the breast while preserving muscle function, performed in concert with a Goldilocks mastectomy. Developed with Dr. Heather Richardson.
A clean, implant-free option that uses what is already there, with a meaningfully shorter recovery than abdominal-flap alternatives. Outcomes published in JACS.
“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.”
Cassileth, Killeen, Richardson. "SWIM Flap: Skin-Sparing, Wise Pattern, Internal Mammary Perforator Breast Reconstruction." JACS, 2020.
Read about SWIM
Refined over years of revision practice
Pocket Lift
Internal-support breast lift technique
Most breast lift techniques rely on skin tension to hold the breast in position. Skin stretches over time. Patients return with the same drop they came in with.
The Pocket Lift restructures the internal breast tissue to provide support from within. Position is held by the structure of the breast itself, not by tension in the skin that will eventually relax.
A more durable lift, more closely matched to how the breast naturally sits, with results that hold up over time.
Read about Pocket Lift“Most lift techniques rely on skin tension. Skin stretches. By restructuring the internal tissue, we get a result that holds.”
Training the field
Inventing isn't enough.
A new technique only matters if other surgeons can do it well. Dr. Cassileth publishes her work in peer-reviewed journals, presents at the American Society of Plastic Surgeons and the American College of Surgeons, and runs Grand Rounds at her own facility every month.
Surgeons who join her practice spend their first months operating alongside her, learning the same protocols and approach before practicing independently. The goal is not just to perform a procedure once. It is to make sure it can be performed correctly, anywhere it is needed.
Considering one of these procedures?
Schedule a consultation with Dr. Cassileth to determine which approach fits your case.
Request a consultation