Fig. 1.

Preoperative photograph of a 51-year-old obese (BMI 32) patient with grade 2 ptosis who demands a single-stage reconstructive procedure. She is wary of regular magnetic resonance imaging to survey the integrity of silicone breast implants and would prefer to never under another surgical procedure after her index operation. She refused immediate bilateral deep inferior epigastric flaps after consultation with a microvascular surgeon. Given her obesity, we feel that the Goldilocks mastectomy with free nipple grafts and LICAP flap is her best reconstructive option. She is shown here 6 weeks after completing chemotherapy for a 2-cm triple negative right breast cancer.