Natural Shaping of Acellular Dermal Matrices for Implant-based Breast Reconstruction via Expansile Kirigami.

To complete a successful and aesthetic breast reconstruction for breast cancer survivors, tissue reinforcing acellular dermal matrices (ADMs) are widely utilized to create slings/pockets to keep breast implants or autologous tissue transfer secured against the chest wall in the desired location. However, ADM sheets are two-dimensional, and cannot completely cover the entire implant without wrinkles. Here, guided by finite element modeling, we present a kirigami strategy to cut the ADM sheets with locally and precisely controlled stretchability, curvature, and elasticity. Upon expansion, a single kirigami ADM sheet can conformally wrap the implant regardless of the shape and size, forming a natural teardrop shape; contour cuts prescribe the topographical height and fractal cuts in the center ensures horizontal expandability and thus conformability. Our kirigami ADM could provide support to the reconstructed breast in the desired regions, potentially offering optimal outcomes and patient-specific reconstruction, while minimizing operative time and cost. This article is protected by copyright. All rights reserved.