Purpose
The surgical technique for autologous breast reconstruction is relatively mature. Nowadays, the focus is not only on achieving successful and low-complication surgeries but also keeping pace with the era of precision medicine, emphasizing minimally invasive techniques and aesthetic considerations.
Material and Method
This study recruit breast cancer patients requiring total mastectomy and minimally invasive reconstruction under three-dimensional(3D) printing assistance. Preoperative routine computer tomography angiography (CTA) was obtained, and surface images of the torso in a seated position will be captured using a handheld infrared 3D camera by the same technician. Software will be used to estimate the preoperative volume of both breasts and to create a digital model of the breast shape (the breast model front piece). A 3D representation of the pectoralis major muscle under the breast tissue (the breast model back piece) will be constructed from the preoperative CTA images to serve as the breast’s foundation. The front and back pieces of the breast model will be printed using a 3D printer with PLA material, establishing a physical framework that fixes the relationship between the front and back pieces. Patient's basic information, surgical details, timing, and postoperative satisfaction are all retrospectively recorded.
Results
Comparing breast reconstruction patients with and without the use of 3D printing, it was found that 3D printing can reduce the flap inset time, minimize incision length, and preserve the inframammary fold. The 3D model will serve as a reference for adjusting the shape of breast flap filling and modification during surgery, minimizing the adjustments and significantly reducing time for flap sculpturing. The technique ensures more accurate bilateral breast volume symmetry, restoring a postoperative symmetrical appearance. Recently, due to the special characters and preciousness of DIEP flap, simultaneous bilateral breast reconstruction with this flap is usually the preferred option for BRCA gene mutation patients. Utilizing 3D printing and intra-operative fluorescence imaging system allows for more precise microsurgical flap design.