Background:

The Goldilocks mastectomy, combined with a modified nipple-sparing approach and the lateral intercostal artery perforator (LICAP) flap, represents an innovative technique for breast reconstruction. This study evaluates the postoperative complications and outcomes of this combined procedure, performed for the first time between November 2023 and January 2025, in a cohort of 27 patients.

Methods:

 A prospective analysis was conducted on 27 patients who underwent the Goldilocks mastectomy with nipple-sparing modification and LICAP flap reconstruction. Postoperative complications, including minor and major infections, delayed wound healing, nipple necrosis, and seroma, were documented and analyzed.

Results:

Among the 27 patients, nipple necrosis was the most frequent complication, occurring in 10 patients (37.0%), followed by delayed wound healing in 9 patients (33.3%). Minor infections were observed in 4 patients (14.8%), while major infections and seroma were each noted in 2 patients (7.4%). Despite these complications, the combination of nipple-sparing modification and 

LICAP flap provided satisfactory aesthetic outcomes and preserved nipple viability in a majority of cases.

Conclusion:

The integration of nipple-sparing modification and LICAP flap with the Goldilocks mastectomy offers a promising approach to breast reconstruction, particularly in patients seeking preservation of nipple aesthetics. However, the high rates of nipple necrosis and delayed wound healing highlight the need for careful patient selection and meticulous surgical technique. This study provides preliminary evidence supporting the feasibility of this combined approach, though further research with larger cohorts and longer follow-up is necessary to optimize outcomes and reduce complications.

Hammad Sheikh completed his FRCS in Breast Surgery from Royal College of Surgeons from Edinburgh. He is serving as HOD Breast surgery since 2017 and has been clinical in innovating and incorporating New surgical techniques to modern day Breast Cancer Surgery. Now he is presenting a Modification to this Oncoplastic Technique. This has already been presented at national level where it was received with overwhelming response and now want to present at International forum