gms | German Medical Science

Introduction: The reconstruction of the breast is a typical procedure in plastic surgery. Body’s own tissue is mobilized and used to shape a new breast. We pursue a clinical approach of stem cell based reconstruction. A customized fat tissue construct can be manufactured with modern 3D imaging and tissue engineering. This construct can be used for esthetic and autologous reconstruction. In this work we demonstrate the feasibility of all necessary methods.

Materials and methods: The surface of a patient is digitalized with laser scanning cameras and converted to a 3d computer model. The healthy breast is mirrored in a CAD program and used as a template for a fat tissue construct. The scaffold for tissue engineering is build by rapid prototyping systems according to the CAD geometries. The features of the scaffold are studied in vitro and in vivo models. The tissue engineering parameters (adhesion, vitality, differentiation) are described by scanning electron microscopy, life/dead staining and oil-red staining. A mouse model is used for neovascularization. A scaffold is implanted using a vessel loop and histologically examined after 4 weeks.

Results: The body of the patient could be digitalized via 3d scanning. We were able to design a perfectly fitting breast with CAD software. This computer model was produced by a rapid prototyping system in correct size and geometries. The stem cells were adherent to Polycaprolactone scaffolds and stayed vital. Adipogenic differentiation was induced and verified by oil red staining. The mouse model showed that vessels are sprouting into the scaffold.

Conclusion: The principle feasibility of the approach was proven in this study: 3d laser scanning allows the fabrication of an individual scaffold and tissue engineering can produce a fat tissue substitute. Vessel loops can vascularized such constructs.