Plasma Surface Modification of 3D Printed Scaffolds for Neurovascularized Nipple-Areolar Complexes

Abstract

For individuals undergoing mastectomy, reconstruction of the nipple–areola complex (NAC) is a critical step in emotional and psychological recovery. However, current clinical approaches—including flap suturing, tattooing, or grafting—are limited by loss of projection, poor mechanical stability, and absence of sensation. Additive manufacturing and tissue engineering offer promising alternatives by enabling the development of hybrid scaffolds that maintain long-term projection and support the potential return of sensation. This review summarizes the state-of-the-art in NAC reconstruction and highlights how advances in additive manufacturing can address existing limitations. Emerging scaffold design strategies allow precise fabrication of biomimetic architectures that replicate the anatomical form and function of the NAC, while supporting tissue integration and mechanical durability. The use of biocompatible polymers such as poly-ε-caprolactone, combined with bioactive coatings and plasma surface modification, enhances cell attachment and vascularization. Additionally, the incorporation of stem cells, multicellular constructs, and conducting polymers is explored to enable multifunctional tissue regeneration and restore sensation through electrical stimulation. By integrating innovations in biomaterials science, regenerative medicine, and advanced fabrication technologies, the field is moving toward nipple reconstructions that are not only more life-like in appearance but also biologically responsive and sensate.

Impact Statement

Reconstruction of a neurovascularised nipple–areola complex remains a major challenge in postmastectomy breast reconstruction. This review highlights advances in plasma-modified 3D-printed poly-ε-caprolactone scaffolds that improve surface hydrophilicity, cell adhesion, and neurovascular integration. Combining plasma surface engineering with additive manufacturing and regenerative strategies offers a pathway to anatomically accurate, mechanically durable, and functionally innervated constructs for next-generation nipple reconstruction.