Goldilocks Mastectomy

The Goldilocks mastectomy is a surgical procedure that serves to remove breast gland tissue while preserving residual healthy fatty tissue and skin that can be arranged to have the appearance of a smaller breast. It is most often offered to women who plan to have mastectomy surgery but do not want or can not have formal reconstruction of their breast or breasts. It can be considered as a treatment option for breast cancer in patients who have enough healthy residual tissue left behind after removal of the cancerous tissue and breast gland. It can also be used as an option for prophylactic surgery in the contralateral breast for patients with breast cancer. Bilateral Goldilocks mastectomy can be performed in patients choosing to have preventative surgery because of increased risk of breast cancer.
The procedure utilizes skin sparing mastectomy technique(1,2,3) which is then combined with a reduction mammoplasty pattern of tissue reconfiguration.(4) It differs from prior mastectomy techniques because it does not require the use of implanted devices or surgical tissue transfer techniques to create fullness of a breast mound after removal of the underlying glandular tissue. This technique of preservation of existing mastectomy tissue and layering it under the upper pole of the breast instead of artificial material to hold an implant in place takes advantage of these principles as well.(5)

It was first publically described by Heather Richardson, MD and Grace Ma, MD from Atlanta Georgia, as part of the ORBS (Oncoplastic and Reconstructive Breast Surgery) meeting in Nottingham, UK on Sept 26, 2011, and was presented as a poster presentation at the American Society of Breast Surgery meeting in Washington, DC April 27-May 1, 2011 for the society's 12th annual meeting. (6) The initial description was accepted for publication in the International Journal of Surgery on August 5, 2012 and published online September 5, 2012. (7)

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