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

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.