Specialized Approaches

Breast reconstruction is never one-size-fits-all. For women who want more than going flat but prefer to avoid implants or complex tissue (flap) surgeries, there’s an option called the “Goldilocks Procedure.” The name comes from the idea of finding something “just right”—not too much, not too little.

What It Is

The Goldilocks Procedure is a type of breast reconstruction performed at the time of mastectomy. Instead of removing all the breast skin and discarding it, your surgeon reshapes the remaining skin, fat, and tissue on the chest to create a smaller, soft breast mound.

• No implants, no flap: Unlike other reconstruction methods, this procedure doesn’t use foreign material or tissue from another body area.

• Uses what you have: The extra skin left after mastectomy is carefully folded, tucked, and reshaped to form a modest breast shape.

• Can be done on one or both sides: It’s an option for women having a mastectomy on one breast or both.

How It’s Done

1. During mastectomy: After the breast tissue is removed, the surgeon keeps more of the skin envelope than in a traditional flat closure.

2. Reshaping: The surgeon folds and sutures this tissue inward, creating a breast mound.

3. Final result: The breast is typically smaller than the original size but provides some natural contour instead of a completely flat chest.

Why Women Choose the Goldilocks Procedure

• No implants required: Good option for women who don’t want—or aren’t good candidates for—implants.

• Less complex than flap surgery: Avoids long operations, extra scars, and recovery from donor sites (like the abdomen or back).

• Shorter recovery: Recovery is usually quicker than flap reconstructions.

• Leaves options open: If desired later, an implant can be placed inside the reshaped mound, or fat grafting can be used to enhance volume.

• Natural appearance under clothing: Even though breasts are smaller, many women appreciate having some shape rather than being flat.

Things to Keep in Mind

• Size is limited: The result is often a small breast mound—closer to an A or B cup. It may not provide much projection or fullness, especially for women with little extra skin or tissue.

• May require revisions: Some women choose to refine the shape later with fat grafting, implants, or minor revisions.

• Not for everyone: If the mastectomy leaves very thin skin or you’ve had significant radiation damage, the procedure may not be possible.

• Appearance varies: Results depend on body type, amount of tissue available, and healing.

Who May Be a Candidate

• Women who prefer a middle ground—more than going flat, but less complex than traditional reconstruction.

• Women with larger or more generous breast tissue, where there’s enough skin/fat to reshape.

• Women who want to avoid implants, donor site scars, or long surgeries.

• Women who may consider future reconstruction steps but want something simple now.

A Personal Choice

The Goldilocks Procedure is about finding the option that feels “just right” for you—not too much, not too little, but a choice that matches your comfort, lifestyle, and healing journey. It can be a comforting “in-between” option for women who don’t feel that implants or flap surgery are right for them. It provides a modest, natural mound and can be the final step—or simply a first step—in reconstruction.