Long-Term Maintenance of Projection of Nipples Reconstructed Using Three-Dimensionally Printed Poly-4-Hydroxybutyrate...

Area of Science:

• Biomaterials Science
• Plastic Surgery
• Tissue Engineering

Background:

• Nipple reconstruction is crucial for patient satisfaction after mastectomy.
• Maintaining nipple projection long-term remains a significant challenge in current reconstruction techniques.

Purpose of the Study:

• To evaluate the efficacy of 3D-printed poly-4-hydroxybutyrate (P4HB) scaffolds for nipple-areola complex reconstruction.
• To assess the long-term projection, mechanical properties, and histological outcomes of these novel scaffolds.

Main Methods:

• Fabrication of 3D-printed P4HB scaffolds, some filled with patient-derived cartilage and others with an internal lattice structure.
• Implantation of scaffolds onto the dorsa of nude rats within a C-V flap.
• Evaluation of neonipple projection, diameter, and mechanical properties at 12 months post-implantation.

Main Results:

• Scaffolded neonipples demonstrated well-preserved projection and diameter compared to controls after one year.
• Histological analysis revealed significant vascularized tissue ingrowth and fibrovascular tissue formation.
• The internal lattice structure promoted faster tissue infiltration and degradation, closely mimicking native nipple biomechanics.

Conclusions:

• Biodegradable P4HB scaffolds effectively maintain nipple projection and mechanical properties for at least one year.
• These scaffolds approximate the histological and mechanical characteristics of native human nipples with a low complication rate.
• Preclinical data support the potential clinical translation of P4HB scaffolds for nipple reconstruction.