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Pectus excavatum camouflage: a new technique using a tissue engineered scaffold

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Abstract

Pectus excavatum is the most common congenital chest wall deformity. Customised silicone implants have been used to camouflage this deformity with good short-term outcomes. In the long term, permanent implants have a significant risk of capsular contracture, migration and extrusion. Scaffold-guided tissue engineering provides an alternative autologous solution which avoids issues associated with permanent implants. We implanted a 3D-printed, custom-made, biodegradable and highly porous scaffold filled with autologous fat graft. We were able to sustain autologous fat in the construct. There was an excellent aesthetic outcome and the highly porous polycaprolactone implant was well tolerated by the patient. This case illustrates the first-in-human trial of soft tissue engineering to camouflage a pectus excavatum defect not reconstructable by conventional techniques.

Level of evidence: Level V, therapeutic study.

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Acknowledgements

The authors would like to thank Mohit P. Chhaya, PhD, and Sara Lucarotti, M.E. (BellaSeno GmbH) for designing and manufacturing the pectus excavatum scaffold.

Author information

Authors and Affiliations

  1. Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia

    Matthew E. Cheng, Jan Janzekovic, Marie-Luise Wille, Michael Wagels & Dietmar W. Hutmacher

  2. Plastic and Reconstructive Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland, 4102, Australia

    Matthew E. Cheng, Harrison J. Theile & Michael Wagels

  3. Plastic and Reconstructive Surgery, Queensland Children’s Hospital, 501 Stanley Street, , South Brisbane, Queensland, 4101, Australia

    Jan Janzekovic, Richard J. W. Theile & Michael Wagels

  4. Faculty of Medicine, University of Queensland, 20 Weightman St, Herston, Queensland, 4006, Australia

    Caitlin Rutherford-Heard

  5. Cardiothoracic Surgery, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland, 4102, Australia

    Chris Cole

  6. Radiology, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland, 4102, Australia

    Thomas B. Lloyd

  7. Australian Centre for Complex Integrated Surgical Solutions, 37 Kent St, Woolloongabba, Queensland, 4102, Australia

    Michael Wagels

  8. Herston Biofabrication Institute, Level 12 Block 7 Royal Brisbane and Women’s Hospital, Cnr Butterfield St and Bowen Bridge Rd, Herston, Queensland, 4029, Australia

    Michael Wagels

Authors
  1. Matthew E. Cheng
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  2. Jan Janzekovic
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  5. Marie-Luise Wille
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  6. Chris Cole
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  7. Thomas B. Lloyd
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  8. Richard J. W. Theile
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  9. Michael Wagels
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  10. Dietmar W. Hutmacher
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Contributions

All authors contributed to this work as defined by the International Committee of Medical Journal Editors.

Corresponding author

Correspondence to Dietmar W. Hutmacher.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This case was reviewed by our institution’s clinical ethics committee where it was agreed that offering the patient an experimental treatment was acceptable (Approval number: HREC/2021/QMS/69789).

Patient consent

The patient gave written consent regarding publishing her data and photographs.

Competing interests

Dietmar W. Hutmacher is a founder and shareholder of BellaSeno GmbH. Matthew E. Cheng, Jan Janzekovic, Harrison J. Theile, Caitlin Rutherford Heard, Marie Luise Wille, Chris Cole, Thomas B. Lloyd, Richard J. W. Theile and Michael Wagels declare that they have no conflict of interest.

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Cheng, M.E., Janzekovic, J., Theile, H.J. et al. Pectus excavatum camouflage: a new technique using a tissue engineered scaffold. Eur J Plast Surg 45, 177–182 (2022). https://doi.org/10.1007/s00238-021-01902-5

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  • DOI: https://doi.org/10.1007/s00238-021-01902-5

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