Next-Generation Biomaterials for Breast Reconstruction: From Tissue Engineering Strategies to Clinical Translation

Breast reconstruction after mastectomy or trauma poses considerable clinical and aesthetic challenges that traditional methods, such as silicone implants and autologous tissue flaps, often insufficiently address. This review analyzes the evolution of biomaterials for breast and soft tissue reconstruction, encompassing conventional ECM-derived scaffolds and acellular dermal matrices, as well as advanced hybrid constructs, injectable smart hydrogels, functionalized biomaterials, and cell-integrated systems incorporating adipose-derived stem cells. Emerging fabrication technologies, including 3D bioprinting, electrospinning, and computational imaging-guided design, are examined for their ability to create patient-specific, vascularized scaffolds with adjustable mechanical and biological characteristics. This review analyzes the scientific basis of soft tissue regeneration, focusing on adipogenesis, angiogenesis, immunomodulation, and extracellular matrix remodeling. The paper further overviews the efficacy of both well-known and new biomaterials, providing a detailed discussion of the translational challenges associated with their clinical application. Despite the substantial recent advancements in the field, comprehensive regenerative breast reconstruction requires ongoing interdisciplinary collaboration and innovation to translate promising preclinical results into safe, effective, and accessible clinical solutions for patients.