Three-dimensional Printing in Plastic Surgery: Current Applications, Future Directions, and Ethical Implications

Abstract

Background: Three-dimensional printing (3DP) is a rapidly advancing tool that has revolutionized plastic surgery. With ongoing research and development of new technology, surgeons can use 3DP for surgical planning, medical education, biological implants, and more. This literature review aims to summarize the currently published literature on 3DP’s impact on plastic surgery. Methods: A literature review was performed using Pubmed and MEDLINE from 2016 to 2020 by 2 independent authors. Keywords used for literature search included 3-dimensional (3D), three-dimensional printing (3DP), printing, plastic, surgery, applications, prostheses, implants, medical education, bioprinting, and preoperative planning. All studies from the database queries were eligible for inclusion. Studies not in English, not pertaining to plastic surgery and 3DP, or focused on animal data were excluded. Results: In total, 373 articles were identified. Sixteen articles satisfied all inclusion and exclusion criteria, and were further analyzed by the authors. Most studies were either retrospective cohort studies, case reports, or case series and with 1 study being prospective in design. Conclusions: 3DP has consistently shown to be useful in the field of plastic surgery with improvements on multiple aspects, including the delivery of safe, effective methods of treating patients while improving patient satisfaction. Although the current technology may limit the ability of true bioprinting, research has shown safe and effective ways to incorporate biological material into the 3D printed scaffolds or implants. With an overwhelmingly positive outlook on 3DP and potential for more applications with updated technology, 3DP shall remain as an effective tool for the field of plastic surgery.

The Utilization of Three-Dimensional Printing in Creating a Surgical Instrument: An Areola Cookie Cutter

“…Its widespread use in surgical planning, simulation, patient education, and the customization of prosthesis has revolutionized the field. 1 Although a number of ethical implications should be taken into consideration, eg, patient consent and conflicts of interest, the benefits of 3D printing in delivering patient-specific care as well as improving patient satisfaction cannot be overlooked. 1 …”

“…Three-dimensional (3D) printing, or rapid prototyping, is an additive manufacturing process that allows for the creation of solid objects from a digital file, and it is a relatively new technology that has found many applications in various fields. 1 The utilization of 3D printing in the medical field has been receiving a growing recognition; it has played a pivotal role in advancing various aspects of the field since its inception. One of its well-recognized uses is in the preoperative planning of complex cases, whereby radiological images, eg, from a computerized tomography (CT) scan, are converted into standard tessellation language (STL) in a process called “segmentation,” and this is then translated by the 3D printer into a model that can be used for planning the surgery.…”

“…One of its well-recognized uses is in the preoperative planning of complex cases, whereby radiological images, eg, from a computerized tomography (CT) scan, are converted into standard tessellation language (STL) in a process called “segmentation,” and this is then translated by the 3D printer into a model that can be used for planning the surgery. 1-3 This has been shown to reduce operation time. 4 Additionally, 3D printing has also been used to create prosthetics and implants, eg, orbital prosthesis, which are accustomed to patients’ specifications.…”

“… 4 Additionally, 3D printing has also been used to create prosthetics and implants, eg, orbital prosthesis, which are accustomed to patients’ specifications. 1 , 5 , 6 One of its overlooked uses is in the creation of surgical instruments. Successful attempts have been made to design, print, sterilize, and use surgical instruments.…”

In-house 3D Model Printing for Acute Cranio-maxillo-facial Trauma Surgery: Process, Time, and Costs

“…This article focuses on a key issue of 3D printing for acute CMF trauma: the time to manufacture a model. Despite most aspects of 3D printing 1 , 12 being perfected for elective reconstructions, models cannot currently be received in time for acute surgery. As a result, we elected and designed an in-house printing process that avoids outsourcing production and shipping delays.…”