3D Printing in Plastic Reconstructive and Aesthetic Surgery: A Guide for Clinical Practice

145 Pages·2022·8.545 MB·English

by  Luigi Di Rosa

3D Printing in Plastic
Reconstructive and
Aesthetic Surgery
A Guide for Clinical Practice
Luigi Di Rosa
Editor
123
3D Printing in Plastic Reconstructive
and Aesthetic Surgery
Luigi Di Rosa
Editor
3D Printing in Plastic
Reconstructive and
Aesthetic Surgery
A Guide for Clinical Practice
Editor
Luigi Di Rosa
STEBICEF Dept.Science, Biotech, Chem
University of Palermo
Palermo, Italy
ISBN 978-3-031-10557-9 ISBN 978-3-031-10558-6 (eBook)
https://doi.org/10.1007/978-3-031-10558-6
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
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To Andrea and Alessandro,
my present and my future.
Foreword
Virtual surgical planning using 3D printing represents one of the greatest techno-
logical achievements of the last decades. The Author, a specialist in Reconstructive
and Aesthetic Plastic Surgery, starting from an examination of the basic technologi-
cal characteristics of 3D printing, introduces us to the use of printing and printers in
a clinical context that mainly concerns aesthetic surgery of the face and of the body.
In the context of the discussion, the opportunity to set up laboratories equipped
with cutting-edge technological tools in large hospitals is recommended to enable
the creation of a virtual model of the patient and design the surgery using dedicated
software. Virtual 3D processing takes place using printers which, with filaments and
resins, allow the creation of models to assist in the planning of surgical interven-
tions and shorten their execution times.
The ability to view the final result of an intervention in 3D format rather than
with 2D images facilitates the dialogue between surgeon and patient, giving the lat-
ter the possibility of an informed decision.
Furthermore, the future of 3D printing is “bioprinting” which represents a great
opportunity for biomedical research and for regenerative medicine in particular. The
repair and regeneration of tissues or entire organs resulting from congenital defects
or acquired diseases can make use of 3D printing of biological material that allows
the generation of living cell layers with the aim of repairing tissues or generating
entire organs.
The subject matter is highly topical as 3D printing and bioprinting represent a
great opportunity for clinical use and biomedical research; at present it is a topic
that has a great economic and social impact, and therefore I offer the author my best
wishes for a great editorial success.
Plastic Reconstructive and Aesthetic Surgery Francesco Moschella
Palermo University
Palermo, Italy
vii
Preface
Since its inception, plastic surgery has been a type of surgery oriented to the future,
always with an eye on innovation, new technologies, and marked by experimenta-
tion; precisely for these reasons, the combination of plastic surgery and three-
dimensional printing was a logical consequence, For some years now, three-
dimensional printing has appeared in medicine revolutionizing both preoperative
planning and anatomical understanding of the patient; however when I started think-
ing about this project, there was no book that dealt in depth with three-dimensional
printing in plastic surgery and how to use three-dimensional printing in an easy way.
Without having the ambition to think that I have written a complete and all-encom-
passing work, my endeavor was to grow the understanding of my fellow surgeons in
the potential this new technology has. This with the hope everyone can understand
that three-dimensional printing is not a technology that can be useful only in aca-
demic environments or research centers, on the contrary, any surgeon can imple-
ment it in his daily work by truly changing his way of doing surgery. I very much
hope that this book will also serve to bring many young colleagues closer to the
study of this fascinating specialty.
The food for thought that I hope you will find in this book is intended to be the
starting point for new and original developments that each of you can find in your
clinical practice.
Don’t be afraid to experiment.
Palermo, Italy Luigi Di Rosa
ix
Acknowledgments
Special thanks go to Madona Samuel, my Project Coordinator for Springer Nature,
and Juliette R. Kleemann, my Editor, because without their help this book would
never have existed. Finally special thanks to Alessandro Gallo from Springer-Verlag
Italia,” Giusy and Maryellen for all their support.
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Contents
1 Introduction to 3D Printing and Printers in a Clinical Setting . . . . . . 1
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1.1 The Historical Backdrop of 3D Printing Innovation . . . . . . . . . . . . 1
1.2 Current 3D Printing Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.3 The Basic Parts of a 3D Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.3.1 Print Bed (Tray) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.3.2 Extruder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.3.3 Hot End . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3.4 Filament . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3.5 Nozzle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 Three-Dimensional Printing Process . . . . . . . . . . . . . . . . . . . . . . . . 7
1.5 The Three-Dimensional Printing Laboratory . . . . . . . . . . . . . . . . . . 10
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2 Filaments and Resins for 3D Medical Printing . . . . . . . . . . . . . . . . . . . 15
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2.1 PLA Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.2 Nylon Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
2.3 ABS Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
2.4 TPU Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.5 TPE Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.6 PVA Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
2.7 HDPE Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.8 PC Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.9 Metal filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.10 Wood Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.11 PP Filaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.12 3D Printing Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
2.13 Standard Photopolymeric Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.14 Dental Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.15 Water Washable Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.16 ABS Like Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
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2.17 FLEX Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.18 Plant Based Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.19 Castable Wax Resins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3 Software for Building an Office-Based 3D Printing Lab . . . . . . . . . . . 23
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3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.2 The DICOM Viewers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.3 Modeling Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.4 Slicing Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
3.5 Image Segmentation and Data Preparation . . . . . . . . . . . . . . . . . . . 26
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
4 3D Printing for Hand Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
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4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
5 3D Printing for Rhinoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
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5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
6 3D Printing for Ear Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
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6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
7 3D Printing for Oculoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
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7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
8 3D Printing in Maxillofacial Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
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8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
9 3D Printing for Whole Body Reconstruction . . . . . . . . . . . . . . . . . . . . . 85
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9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
10 3D Printing for Aesthetic and Reconstructive Breast Surgery . . . . . . . 91
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10.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100