SWIM Flap: Skin-Sparing, Wise Pattern, Internal Mammary Perforator Breast Reconstruction

Cassileth, Lisa B.; Killeen, Kelly L.; Richardson, Heather

doi:10.1016/j.jamcollsurg.2019.12.015

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Since its description in 2012, the Goldilocks procedure has become an increasingly used technique for postmastectomy breast reconstruction. 2,3,5,10,14–24 However, there has been no literature describing patient-reported outcomes and whether additional operations were required for these patients after the Goldilocks procedure. This option is frequently offered as a single-stage operation to patients with high body mass indexes and medical comorbidities that make them poor candidates for more complex options including implant-based and autologous breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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

Manrique

Kuruoglu

Yan

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Since its first description in 2012, the Goldilocks procedure has become an option for immediate breast reconstruction, particularly for obese patients who are poor candidates for traditional implant or autologous reconstruction. In this work, the authors performed a longitudinal study of patients who underwent mastectomy with Goldilocks reconstruction to assess the incidence of additional surgical procedures, and to assess surgical outcomes and patient satisfaction. Methods: A retrospective review of patients who underwent mastectomy with the Goldilocks procedure only at Mayo Clinic Rochester between January of 2012 and September of 2019 was performed. Demographics, complications, additional breast procedures performed to attain the final results, and patient-reported outcomes using the BREAST-Q were recorded. Univariate and multivariable analyses were performed to identify statistical associations and risk factors. Results: Sixty-three patients (108 breasts) were included. Mean age was 57.8 years. Mean body mass index was 37.6 kg/m2. Median follow-up time after the mastectomy with the Goldilocks procedure was 15 months. The major complication rate within the first 30 days was 9.3 percent. Forty-four breasts (40.7 percent) underwent additional surgery. Dyslipidemia was significantly associated with an increased risk of additional surgery (adjusted hazard ratio, 2.00; p = 0.045). Scores in the four BREAST-Q domains were not statistically different between patients who had additional procedures and those who did not. Conclusions: Based on the results, the authors recommend a thorough preoperative discussion with patients who are candidates for the Goldilocks procedure to explore all options for reconstruction and their expectations, because it is crucial to reduce the necessity for additional operations in this high-risk population. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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Section: Discussionmentioning

confidence: 99%

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

Manrique

Kuruoglu

Yan

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…Further advancements have allowed the preservation of the nipple-areolar complex using a dermal pedicle or a Skin-sparing, Wise patterns, Internal Mammary perforator (SWIM) flap [13][14][15]. Goldilocks mastectomy has also been employed as a baseline for secondary breast reconstruction procedures and as a salvage option for failed reconstructions or as a bridge to secondary reconstructive procedures [8].…”

Section: Discussionmentioning

confidence: 99%

Goldilocks Mastectomy: The Middle Road Option for Obese Breast Cancer Patients

Tong,

Cohen-Hallaleh

2023

Cureus

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Breast cancer is the predominant cancer affecting females in Australia. With the rising obesity rates, the number of obese breast cancer patients is also rising. Full complex breast reconstruction is known to carry significant risk of complications in obese patients, hence we sought to utilize Goldilocks mastectomy as an alternative middle-ground option between standard mastectomy and complex breast reconstruction.A 63-year-old obese female presented with left nipple inversion. Ultrasonography revealed a 9.7 mm dilated retroareolar duct within the left breast, indicating lobular carcinoma. Subsequent biopsy analysis revealed estrogen/progesterone receptor (ER/PR)-positive cancer with equivocal human epidermal growth factor receptor 2 (HER2) status and a Ki67 index of 10%. Concurrently, a discrete area of conspicuous breast tissue prominence displayed characteristics of invasive ductal carcinoma with similar receptor status but a reduced Ki67 index of less than 5%. Traditional breast reconstruction options were unfavorable due to obesity, prompting consideration of a tailored Goldilocks mastectomy. The procedure was uncomplicated, and follow-up assessments revealed commendable wound healing, alongside the restoration of symmetrical breast contours.Conclusion: This study highlights the significance of Goldilocks mastectomy as an invaluable technique in the comprehensive management of breast cancer, particularly for obese patients characterized by a body mass index (BMI) exceeding 35 and substantial medical comorbidities.

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SWIM Flap: Skin-Sparing, Wise Pattern, Internal Mammary Perforator Breast Reconstruction

Cited by 2 publications

References 8 publications

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

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

Goldilocks Mastectomy: The Middle Road Option for Obese Breast Cancer Patients

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