From printer to patient: A scoping review and new classification of ready-to-use three-dimensional printed constructs in autologous breast reconstruction.

[BACKGROUND] Three-dimensional (3D) printing has been successfully used in several plastic and reconstructive surgery subspecialties; however, it is still a relatively new concept in the field of autologous breast reconstruction. There is no study describing these 3D-printed constructions and their clinical impact in autologous breast reconstruction.

[METHODS] We conducted a scoping review and searched PubMed, Embase, Web of Science, Cochrane, and Scopus. From these articles, we extracted data regarding the 3D-printed construct, the timepoint at which the construct was used, the types of surgeries the construct was used in, the method, material, and cost to 3D print the construct, intraoperative time, length of hospitalization, postoperative complications, and various outcomes.

[RESULTS] We retrieved 329 articles, 11 of which met our inclusion criteria. There was a total of 137 3D-printed constructs described in the literature. We classified the three types of constructs as such: Type IA are breast bio-models (2.9%, n = 4), Type IB are breast molds (32.8%, n = 45), and Type II are perforator templates (64.2%, n = 88). Three studies reported significant reductions in intraoperative time when using 3D-printed constructs, but no significant reductions in postoperative complications, reoperations, or flap failures. These three constructs serve both preoperative and intraoperative functions for a wide range of autologous reconstructions.

[CONCLUSIONS] Three-dimensional printing represents a promising new technology in autologous breast reconstruction. We developed a new classification system for ready-to-use 3D-printed constructs that can be used as a guide for future applications in autologous breast reconstruction.