Improving Outcomes in Breast Reconstruction: From Implant - based Techniques towards Tissue Regeneration

Patients undergoing mastectomy for breast cancer have nowadays many options for breast reconstruction, that will help in re-establishing patient's self confidence in her own body image. Implant-based reconstruction remains the most common form of post-mastectomy reconstruction, but it could also present some complications, the most common being capsular contracture. Accordingly, a novel breast mound may be perfectly designed using the reverse engineering approach and additive manufacturing methods combined with autologous fat grafting. A 3D hierarchical structure with autologous adipose-derived stem cells may be used as a construct for tissue regeneration. The 3D morphologically controlled scaffold may be placed in the subcutaneous position at the level of the conservative mastectomy side. The scaffold will be colonized with autologous fat tissue in some sessions. The biodegradable customized structure will help to maintain the breast shape and the natural consistency may be obtained with the fat grafting, also considering adequate enhancement techniques (Stromal Vascular Fraction derived growth factors). The principles of regenerative medicine may be combined and integrated with those of reverse engineering (3D image capture, 3D modelling and rapid prototyping) to design custom-made and high functional hierarchical structures with tailored properties and 3D complex geometry. The current study will focus on the basic principles and strategies in designing 3D advanced and complex structures for breast repair and regeneration.