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

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.