Manrique, Oscar J.; Kuruoglu, Doga; Yan, Maria; Bustos,
Samyd S.; Boughey, Judy C.; Harless, Christin A.; Tran, Nho V.; Martinez-Jorge,
Jorys; Forte, Antonio J.; Nguyen, Minh-Doan T.
Plastic and Reconstructive Surgery: April 2022 -
Volume 149 - Issue 4 - p 801-809
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.
