Arch Aesthetic Plast Surg.  2020 Jul;26(3):118-120. 10.14730/aaps.2020.02082.

An alternative method to create a breast mound after tissue expander insertion: The modified Goldilocks technique

  • 1Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea


With the recent increase in reported cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), fears of breast implants have increased. In particular, some patients now desire expander removal without implant insertion. In the case described herein, a 41-year-old female patient who had undergone a skin-sparing mastectomy with expander insertion due to breast cancer requested expander removal due to fear of BIA-ALCL during expansion. The authors modified the Goldilocks technique to prevent a chest wall deformity due to expansion. The expanded skin was sufficiently thick, as it was engrafted with acellular dermal matrix, and some of it was de-epithelized and rolled in. The patient’s chest wall depression was completely corrected and an acceptable breast mound was created. To summarize, this technique was used to correct a chest wall deformity and to form a breast mound in a patient who underwent expander removal without implant insertion.


Acellular dermis; Tissue expansion devices; Breast implant; Breast mound
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