Emerging Applications of Bedside 3D Printing in Plastic Surgery

Abstract

Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.

Enhancing breast projection in autologous reconstruction using the St Andrew’s coning technique and 3D volumetric analysis

“…3D printing describes a technology where haptic biomodels are fabricated in a layer-by-layer fashion using CAD files derived from routine medical imaging sources, such as 3D photography, CT and MRI scans (38)(39)(40). In contrast to the current medical imaging techniques, clinicians are able to interact hands-on with the 3D-printed biomodels, which enables a superior understanding of visuospatial relationship between the patient-specific anatomical structures.…”

“…3D printing, also known as additive manufacturing or rapid prototyping, is a novel technology that can fabricate haptic biomodels of patient-specific anatomical structures using various imaging sources, such as 3D photography, CT scan, and magnetic resonance imaging (MRI) (38)(39)(40). In the last decade, 3D printers have become more affordable and convenient to use.…”

Three-Dimensional Printing: A Novel Technology for Use in Oral and Maxillofacial Operations

“…MakerBot Replicator 2X Experimental (MakerBot Industries, New York, NY, USA), Cube 3 (3D Systems, Rock Hill, SC, USA), and Creatr x1 (Leapfrog, Emeryville, CA, USA) are known for this ability. Even more, the second extruder can be configured to build support structures using MakerBot Dissolvable Filament (MakerBot Industries), made of highimpact polystyrene (HIPS) [6,46].…”

Application of a 3D custom printed patient specific spinal implant for C1/2 arthrodesis

“…Having gained much interest in recent years, 3DP has found applications in many surgical and medical fields, with variations in printing solutions permitting various options in the architecture of the final structure across a wide range orthopaedic and facial or plastics procedures (1,2). The application of 3DP in orthopaedics is only recent, with positive early results demonstrating the potential to alter future orthopaedic practice (3,4).…”