Hamed Mohamed Lofty
From the Department of Plastic Surgery, Innovinity Medical Hub, Cairo, Egypt.
Alive Biotechnology Solutions UK, London, England.
Plast Reconstr Surg Glob Open. 2024 Dec 13;12(12):e6386. doi: 10.1097/GOX.0000000000006386. eCollection 2024 Dec.
Current breast augmentation options face limitations and potential associated complications. Implant-based augmentation introduces risks such as capsular contracture and malpositioning, whereas fat grafting poses issues such as induration and infections, necessitating revisions. Tissue engineering, integrating 3-dimensional (3D) printing and biomaterials science, aims to overcome these challenges. However, the clinical translation of these advancements remains challenging, with many approaches falling short in demonstrating the necessary volume regeneration. A 28-year-old yoga instructor with a disinterest in traditional options sought an alternative solution. Custom-made biocompatible thermoplastic copolyester implants were proposed, approved, and implemented. Our approach utilized artificial intelligence, magnetic resonance imaging, computer-aided design, and lattice structure engineering for customizing the implant design. Three-dimensional printing and plasma technology surface treatment created implants of 300 and 315 cm volumes, weighting around 33 g with biomimetic properties. Implants were placed in the subglandular plane; an 8-month follow-up revealed well-maintained implants without complications, except for a conservatively managed hematoma, and excellent cosmetic outcomes. Magnetic resonance imaging analysis revealed revascularization and new tissue formation within the implant, demonstrating tissue integration without complications. The study addresses biomechanical issues and foreign body reactions that cause capsular contracture in breast augmentation and proposes a novel 3D-printed implant with ultralight weight, tissue integrative porous structure, and biomimetic environments for scaffold-guided tissue regeneration. In conclusion, the presented solution shows promise in overcoming current breast augmentation limitations, demonstrating safety, biocompatibility, and patient satisfaction. Further adoption and long-term studies with larger cohorts are needed to validate its clinical effectiveness and feasibility.
当前的隆胸选择存在局限性和潜在的相关并发症。基于植入物的隆胸手术存在诸如包膜挛缩和位置不当等风险，而脂肪移植则存在硬结和感染等问题，需要进行修复。组织工程学结合了三维（3D）打印和生物材料科学，旨在克服这些挑战。然而，这些进展的临床转化仍然具有挑战性，许多方法在证明必要的体积再生方面存在不足。一名对传统选择不感兴趣的28岁瑜伽教练寻求替代解决方案。定制的生物相容性热塑性共聚酯植入物被提出、批准并实施。我们的方法利用人工智能、磁共振成像、计算机辅助设计和晶格结构工程来定制植入物设计。三维打印和等离子体技术表面处理制造出体积为300和315立方厘米、重量约为33克且具有仿生特性的植入物。将植入物放置在乳腺下平面；8个月的随访显示植入物保持良好，无并发症，除了一个经保守治疗的血肿，并且美容效果极佳。磁共振成像分析显示植入物内有血管再生和新组织形成，表明组织整合且无并发症。该研究解决了隆胸手术中导致包膜挛缩的生物力学问题和异物反应，并提出了一种新型的3D打印植入物，其具有超轻重量、组织整合性多孔结构和用于支架引导组织再生的仿生环境。总之，所提出的解决方案在克服当前隆胸局限性方面显示出前景，证明了安全性、生物相容性和患者满意度。需要进一步采用并对更大队列进行长期研究以验证其临床有效性和可行性。
