Grants Funded

Abstract
In this project we propose a novel approach for reconstruction of the nipple utilizing 3D-printed external scaffolding in combination with minced costal cartilage, which is normally discarded in a local flap breast reconstruction, as a biological, autologous permanent filler. As opposed to the current approaches in which local skin, fat, or synthetic materials are used to create a nipple, in pilot studies, our costal cartilage constructs can more reliably maintain the size and contour of the neo-nipple, resulting in more predictable outcomes. This is achieved by our custom designed 3D external scaffold, printed out of biocompatible and biodegradable material, which supports the implanted filler during initial maturation phase of the implant that would otherwise undergo contracture and loss of contour. The mincing of the costal cartilage also has the potential to allow for better replication of the biomechanics of the native nipple, a crucial factor which current approaches fail to achieve. In this project we will further evaluate the practicality of this approach using an animal model of nipple reconstruction in which a commonly used CV flap will be created on the dorsa of rats and minced costal cartilage (either scaffolded or naked) will be implanted as a filler material. Gross analysis of the formed neo-cartilage, its contour and projection will be compared over longer time points to assess the affect of the external scaffolding. CT scanning will also be used to more accurately assess volume changes over time as it compares between naked and scaffolded constructs. Histological analysis will be done to evaluate viability of constructs over time and its integration with the surrounding tissue. We will also assess, for the first time, the mechanical properties of the native nipple to help the engineering and reconstructive community better understand the structure we aim to recreate. This approach uses the patient's own costal cartilage to recreate the nipple, which eliminates the need for a separate procedure or donor site when done intraoperatively as a part of the initial breast reconstruction and allows for a potentially life-long lasting reconsruction . Importantly, we aim to fabricate a more realistic reconstruction of the native nipple, as compared to current methods in terms of contour, projection, and biomechanical character, that can rapidly be translated from animal model to humans.

Biography
Jaime L. Bernstein is a first-year integrated plastic and reconstructive surgery resident at New York-Presbyterian-Cornell/Columbia. Jaime received her MD with honors in research from Weill Cornell Medical College in 2018. She also received her Masters in Science in Clinical and Translational Research from Weill Cornell Graduate School of Medical Sciences in 2018. She is a member of Alpha Omega Alpha and received an National Institute of Health TL1 grant to conduct tissue engineering research during medical school. Jaime has received numerous nationally-based merit scholarships during medical school and has been an author on over 50 peer reviewed papers and abstracts.