Introduction: Immediate reconstruction post mastectomy is on the rise with greater access to services and an increase in awareness of the benefits for patients. The Goldilocks technique offers partial breast reconstruction using inferior mastectomy flaps in patients who are poor candidates for traditional approaches or who would prefer to have shorter less complicated surgery at the time of mastectomy. Second stage procedures can be considered in patients wishing to proceed to implant based reconstruction in the future. Method: We present 6 cases who underwent a Goldilocks procedure and assessed their cosmetic outcomes and complications. Patients’ comorbidities including Body Mass Index (BMI) and genetics data were collected as well as cancer pathology and adjuvant therapy. Results: The patients included in this study were morbidly obese with BMI ranging from 36 to 70. Two patients were BRCA gene carriers. Most patients required systemic chemotherapy and some required radiotherapy. Most patients achieved a satisfactory cosmetic outcome and there were no major complications recorded. Conclusion: Patients with a high BMI pose a significant challenge to traditional reconstructive options as surgery is more difficult with higher complications rates. Goldilocks dermal flap partial reconstruction is a favourable option for those deemed too high risk for autologous or implant based reconstruction and have the option to proceed to second stage subpectoral implant placement, or a revision autologous option once BMI has come down to an acceptable level.