Outcomes analysis of Goldilocks mastectomy and breast reconstruction: A single institution experience of 96 cases

Abstract

Background The Goldilocks mastectomy procedure involves local contouring of completely autologous breast tissue created by preserving and de‐epithelializing the residual mastectomy flaps. The purpose of this study was to provide outcomes data for 96‐Goldilocks mastectomy procedures analyzing indications, complications, relevant comorbidities, and adjuvant cancer treatment impacting reconstructive and aesthetic outcomes. Methods Comprehensive review of every patient who underwent Goldilocks mastectomy from 2012 to 2018 included relevant medical and surgical comorbidities, as well as complication profiles. Aesthetic outcomes were also assessed in those with postoperative imaging available. Results A total of 53 patients (96 breasts) were included in this study. Bilateral cases consisted of 81.1% of the total cohort (n = 86 cases), and 18.9% (n = 10 cases) were unilateral procedures. Mean age at the time of reconstruction was 55.8 (33‐77) years. Mean body mass index (BMI) at the time of reconstruction was 33.7 (19.2‐54.6). The overall complication rate was 9.38% (seroma = 2, hematoma = 1, cellulitis = 2, wound dehiscence = 3, and operating room take back = 1). Conclusions Goldilocks breast reconstruction is a safe, effective option in patients with higher than average BMI or excess local breast tissue, or in patients meeting these criteria preferring a single‐stage reconstruction. This study qualifies its use in patients with higher than average risk factors for more extensive reconstructive modalities.

Immediate Breast Reconstruction Using the Goldilocks Procedure: A Balance between More Surgery and Patient Satisfaction

“…The overall complication rate after mastectomy with the Goldilocks procedure remained in the range of 8 to 9.4 percent according to the previous studies and the current study. 2,3 Furthermore, implant-based reconstruction with postmastectomy radiation therapy has been reported to carry higher risk for complications when compared to other techniques. 27 The Goldilocks technique can avoid the disadvantages attributable to the presence of an implant in the setting of postmastectomy radiation therapy.…”

“…The literature has multiple reports attributing higher complication rates in patients with a body mass index greater than 35 kg/m 2 . 1–5 The Goldilocks procedure represents an option for breast reconstruction for those patients who do not want to go flat or undergo complex, multistage breast reconstruction. 2–4,6–8…”

Goldilocks Procedure without a Vertical Incision and a Comprehensive Literature Review

“…This approach is not a complete substitute for formal breast reconstruction but is an alternative to near-total mastectomy in patients who may be poor candidates for traditional reconstruction or those patients who prefer a one-stage reconstruction without the time commitment and potential morbidities of traditional multistage reconstruction. 13 …”

Optimizing aesthetic outcomes after Goldilocks mastectomy: A new method of nipple reconstruction

“…In this technique, a breast mound is created by preserving and de-epithelializing the residual mastectomy flap [2].This technique is suitable for women who decline, or are unsuited for, traditional post-mastectomy reconstruction, especially those with significant medical comorbidities. It is a safe, effective option in patients with a higher than average body mass index and is a safe alternative when reconstruction of breast mounds has been unsuccessful [3].The Goldilocks breast reconstruction offers good aesthetic outcomes and long-term results [1,4]. Although this technique achieves a good appearance, the removal of the nipple-areolar complex often has a traumatic effect on the patient.…”

“…The Goldilocks breast reconstruction offers good aesthetic outcomes and long-term results [1,4]. Although this technique achieves a good appearance, the removal of the nipple-areolar complex often has a traumatic effect on the patient.…”