High-Volume Fat Grafting With and Without Goldilocks Mastectomies Show Successful Clinical Outcomes for Breast Reconstruction

High-volume fat grafting is an autologous reconstructive technique that provides women with a minimally invasive surgical option, yet there remains a paucity of literature examining details about the reconstructive timeline and outcomes of this procedure. This study presents a retrospective review of a single surgeon's experience performing total autologous breast reconstruction using fat grafting alone or in combination with Goldilocks mastectomies. Our population included 39 breast reconstructions in 25 patients. Nineteen patients (28 breasts) had fat grafting only and 6 patients (11 breasts) had Goldilocks and fat grafting. On comparison, the fat grafting only group averaged 4 grafting sessions while the Goldilocks combined group averaged 2.64 sessions (P = 0.03). In the fat grafting only group, the total average volume of fat injected into each breast was 664 mL, and it was not significantly different from the Goldilocks combined group with 495 mL of fat (P = 0.111). In the fat grafting only group, there was a similar amount of fat injected in the first 5 grafting sessions; following the 5th session, there was a significant drop in volume grafted (P < 0.001). Four fat grafting-related complications were reported (10%) and 3 patients developed seromas following their Goldilocks mastectomies (27%). There were no tumor recurrences. We can conclude from this data that high-volume fat grafting is a successful and safe form of breast reconstruction. We show good volume achieved with minimal procedures necessary, especially when combined with Goldilocks mastectomies. This study depicts a reliable timeline for this autologous and safe reconstructive option.