Natural Shaping of Acellular Dermal Matrices for Implant-Based Breast Reconstruction via Expansile Kirigami

Adv Mater. 2023 Feb;35(6):e2208088. doi: 10.1002/adma.202208088. Epub 2022 Dec 19.

Abstract

To complete a successful and aesthetic breast reconstruction for breast cancer survivors, tissue reinforcing acellular dermal matrices (ADMs) are widely utilized to create slings/pockets to keep breast implants or autologous tissue transfer secured against the chest wall in the desired location. However, ADM sheets are 2D and cannot completely cover the entire implant without wrinkles. Here, guided by finite element modeling, a kirigami strategy is presented to cut the ADM sheets with locally and precisely controlled stretchability, curvature, and elasticity. Upon expansion, a single kirigami ADM sheet can conformably wrap the implant regardless of the shape and size, forming a natural teardrop shape; contour cuts prescribe the topographical height and fractal cuts in the center ensures horizontal expandability and thus conformability. This kirigami ADM can provide support to the reconstructed breast in the desired regions, potentially offering optimal outcomes and patient-specific reconstruction, while minimizing operative time and cost.

Keywords: acellular dermal matrix; breast reconstruction; expansile kirigami; natural and conformal shaping.

MeSH terms

  • Acellular Dermis*
  • Breast Implantation*
  • Breast Implants*
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mammaplasty*
  • Tissue Expansion