Objective:
Accurate shaping and volume adjustment remain challenging in autologous breast reconstruction. The introduction of 3D-printed breast molds with pores may improve intraoperative precision and postoperative outcomes. This study aimed to evaluate whether the use of porous molds in in flap inset influences both objective and patient-reported outcomes compared with the conventional techniques.

Materials and Methods:
From December 2021, to November 2024, data from 70 patients who underwent DIEP flap reconstructions with the full VGHTPE protocol, incorporating 3D-printed porous breast templates, were prospectively collected. Patients with total flap failure were excluded. Outcomes were compared with the conventional group who performed DIEP flap reconstruction without 3D-printed mold technique. Patient-reported outcomes were assessed with the Breast-Q questionnaire at baseline and at least six months postoperatively. Objective results were analyzed using pre- and postoperative photographs, BCCT.core software evaluation, and surgical revision rates. Minimum follow-up was six months.

Results:
Patients reconstructed with 3D-printed molds demonstrated higher satisfaction scores across all Breast-Q domains at six months compared to the conventional cohort. Objective cosmetic assessments with BCCT.core confirmed improved breast symmetry and contour accuracy in the 3D-printed mold group. The rate of secondary cosmetic revisions was reduced, with fewer cases requiring correction of volume asymmetry or contour deformity. No significant differences in complication rates were observed between groups.

Conclusion:
The integration of pore-incorporated 3D-printed breast molds in DIEP flap inset enhances both subjective and objective reconstructive outcomes. This approach improves shape accuracy, reduces revision rates, and supports broader adoption of template-assisted techniques in autologous breast reconstruction.