Goldilocks Mastectomy with Immediate Implant or Flap Placement

In patients that want a more definitive reconstruction, Dr. Schwartz can sometimes add an implant at the time of the Goldilocks Mastectomy or a tissue flap from the side or back. He first described simultaneous addition of a tissue flap to the Goldilock Mastectomy to obtain a more definitive reconstruction. While addition of an implant to the Goldilock Mastectomy only adds on 30-45 minutes for both sides, Goldilocks Mastectomy with a tissue flap takes at least 3 hours for one side and 7-8 hours for both sides. Goldilock Mastectomy and immediate implant placement is performed in our Ambulatory Surgery Center without hospital admission with drain care and recovery similar to the standard Goldilocks Mastectomy Surgery. While the Goldilock Mastectomy with tissue flap placement on one side can be performed in our surgery center without hospital admission, we perform this surgery on both sides in the hospital with overnight observation. For patients that elect to have a tissue flap placed, they have an additional scar that extends from the front to the back in the bra line. An additional drain is also placed into the back for seven to 14 days. Recovery from the Goldilocks Mastectomy with immediate flap placement takes 2-4 weeks depending on whether it done on one or both sides.

Dr. Schwartz has also described the Goldilock Mastectomy as a safe first-stage operation in high-risk overweight patients in preparation for a safe second-stage implant placement. Immediate implant placement after mastectomy in patients with high BMI has been shown to have a very high risk of failure and should not be performed in a single stage. By staging this procedure and allowing the Goldilocks mastectomy incisions to heal first, second stage implant placement is extremely safe and reliable. In some patients who would prefer to avoid an implant, Dr. Schwartz has also described the use of fat or a tissue flap transfer in a second stage.