State of Research on Tissue Engineering with 3D Printing for Breast Reconstruction

This review investigates the intersection of tissue engineering and 3D printing technologies in the realm of breast reconstruction, underscoring the transformative potential these approaches offer for enhancing post-mastectomy outcomes. It encompasses a detailed examination of current methodologies, focusing on the creation of biocompatible, bioabsorbable scaffolds that adeptly mimic the extracellular matrix to promote tissue integration and regeneration. A significant portion of the analysis draws from a search conducted on PubMed, which aimed to collate relevant preclinical and clinical studies in this domain. This search underscored the nascent stage of many applications, highlighting a critical need for more comprehensive preclinical trials to validate the efficacy and safety of these innovative solutions. Our search revealed that many studies have studied alternatives for breast reconstruction using tissue engineering; with a significant proportion of these modalities focusing on using flaps inside 3D-printed chambers. Moreover, although some studies have shown significant adipose tissue growth, their results still do not approximate breast dimensions. Specifically, the review identifies a limited range of polymers that have been explored in preclinical and clinical studies for breast reconstruction, including tissue-engineering chambers and scaffolds for the reconstruction of the breast mound made of poly-lactic acid, poly-glycolic acid, poly-lactic-co-glycolic acid, poly-4-hydroxybutyrate, polycarbonate, and polycaprolactone. For nipple reconstruction, two studies assessed scaffolds made of poly-4-hydroxybutyrate and poly-lactic acid. The review highlights the utilization of bioabsorbable materials in these devices, indicating the potential for performing one-stage surgeries. Moreover, it elaborates on the biomechanical properties of these materials, aligning them with the specific goals of breast reconstruction. The review acknowledges the complexity of navigating regulatory landscapes, suggesting that overcoming these obstacles is essential for clinical translation. Despite these challenges, the convergence of 3D printing and tissue engineering is presented as a paradigm shift in breast reconstruction, offering the potential to significantly enhance aesthetic and functional outcomes, minimize post-surgical complications, and improve patients' quality of life.