3D Bioprinting of Skin Tissue Engineering in Cosmetic and Reconstructive Surgery; Current Strategy, Challenges and Future perspective

3D Bioprinting of Skin Tissue Engineering in Cosmetic and Reconstructive Surgery; Current Strategy, Challenges and Future perspective
bita dehghani,¹ Mehdi Atari,^2,*
1. Apadana Institute of Higher Education
2. Apadana Institute of Higher Education
Introduction: Patients with diseases causing tissue and organ damage face physical and psychological challenges. Conventional surgical treatments often fall short in addressing these issues, especially in cases like deep burns that destroy hair follicles and impact appearance and mental health. Skincare products aim to enhance skin health, but there is a demand for natural ingredients and customization in the cosmetics industry. Reconstructive and plastic surgery treat a variety of disorders affecting different tissues, focusing on restoring physical integrity and functionality. Traditional biomaterials like silicones may not meet the precise needs of patients, and autologous tissue transplantation poses challenges like donor site damage. Tissue engineering and 3D bioprinting are gaining attention for their ability to create customized implants and bionic skin substitutes that can address these limitations. With high resolution, flexibility, reproducibility, and efficiency, these technologies show promise in developing tissue-engineered skin to meet both industrial and clinical needs.
Methods: 3D printing (3DP) technologies have advanced to the point where highly detailed biomimetic scaffolds can be created, replicating the characteristics of native tissue more accurately than ever before. 3D bioprinting allows for precise replication of native skin through computer-controlled placement of cells and scaffolds in controlled patterns, influencing macro, micro, and nanoarchitecture. This technique has applications in cosmetic and reconstructive surgery, offering authentic, scalable, and reproducible results compared to conventional methods. By strategically placing different cell types and structures, bioprinted skin reduces the complexity, risk, and recovery time associated with plastic surgery. Tissue engineering offers further possibilities for reconstruction, utilizing bioactive molecules and tissues to enhance beauty and reduce morbidity associated with implantable devices. Scaffold materials play a crucial role in tissue engineering, guiding cell differentiation and functionality. Synthetic and natural polymers have been utilized in bioengineered skin grafts, with potential for microneedles loaded with active ingredients. Various cell types, including fibroblast, keratinocytes, and stem cells, have been explored for creating artificial skin substitutes, with promising hydrogel systems offering new opportunities for tissue engineering and skin production.
Results: 3D printing allows for customizing dressings to meet specific needs by providing spatial precision and flexibility to mimic natural tissues' characteristics. It offers advantages in customization, stability, design flexibility, and functional materials, with bio-ink options supporting skin regeneration. The scaffolds enable perfect cellular interactions and the development of new tissues through their large surface area and small pore sizes. Compared to traditional methods, 3D bioprinting has advantages like timeliness and high repeatability when creating skin grafts matching scar defects. A perfect skin scaffold should have mechanical, chemical, biological, and physical features like porosity, biodegradability, and elasticity. Artificial skin patches made through 3D printing can help in scar management by dividing large scars into smaller segments. Researchers are exploring novel techniques, like reprogramming fibroblasts, to create pluripotent cells for tissue engineering. Combining these cells with 3D printing may lead to functional tissue-engineered skin mimicking natural skin properties.
Conclusion: 3D bioprinting technology offers a solution to surgical complications and adverse reactions associated with traditional procedures, providing customized products tailored to individual needs. It is used for tissue regeneration, scaffolds, and skin delivery platforms in tissue engineering applications. Benefits include reduced donor site morbidity and the creation of in vitro tumor models like malignant melanoma. Despite advancements, challenges remain in replicating complex skin structures. Seeded cells play a crucial role in skin repair and engineering, with the goal of restoring skin functions efficiently. However, obstacles such as resolution, vascularity, cell-scaffold combinations, and cost need to be addressed before clinical applications. This technology allows for the production of biomimetic skin substitutes, catering to both clinical and industrial needs. The ability to customize products based on individual requirements is a growing trend, with active ingredients or boosters added to mass-produced cosmetics for personalization. Users can select qualities based on their skin type, leading to tailored products. Small-scale 3D skin tissue models are likely to be used initially for drug testing, cosmetics, and tumor modeling before clinical applications. Ultimately, 3D bioprinting has the potential to revolutionize tissue engineering and cosmetic surgery, offering personalized treatment options and complex geometric distributions with biomaterials and growth factors.
Keywords: 3D bioprinting, Skin Tissue Engineering, Cosmetic Surgery, Biomimetic, Biomaterials