The appeal of the approach lies in its simplicity and accessibility. Previous attempts to bring three-dimensional printing into breast reconstruction have generally depended on computed tomographic angiography data or dedicated surface-imaging platforms, both of which carry substantial costs and infrastructure requirements. CT-based workflows also expose patients to additional radiation when imaging has not already been obtained for surgical planning, and image segmentation demands specialized expertise that many centers cannot easily mobilize at the point of care. By contrast, the new technique uses the structured-light TrueDepth camera already built into an iPhone, capturing surface geometry through the ScandyPro application in a matter of minutes during an ordinary outpatient appointment.

Before applying the method to patients, the research team validated the accuracy of smartphone scanning against a professional-grade alternative. They fabricated a physical breast phantom from an open-source digital model using fused deposition modeling, then scanned it with two protocols. The smartphone protocol used ScandyPro on an iPhone 12, which reconstructs surfaces from the infrared depth data of the front-facing camera. The comparison protocol used a Canon digital single-lens reflex camera with a 24 millimeter lens, acquiring 100 to 150 photographs in circular passes at varying elevation angles and reconstructing them through photogrammetry in Agisoft Metashape. Fiducial markers provided correspondence points and a calibration bar of known length fixed the absolute scale, since structure-from-motion reconstructions are otherwise ambiguous in size.

The geometric comparison was carried out in CloudCompare using a two-stage registration procedure. A coarse alignment was first computed by manually selecting corresponding fiducial points, followed by fine registration with the Iterative Closest Point algorithm restricted to rigid-body motion, so that genuine geometric deviation was preserved rather than absorbed by the fit. The results were striking: smartphone scans showed a mean deviation of just 0.033 millimeters and a root-mean-square error of 0.697 millimeters, with individual scans ranging from 0.456 to 0.878 millimeters. Every smartphone scan outperformed the DSLR photogrammetry reconstruction, which recorded an RMSE of 0.954 millimeters. Both methods achieved sub-millimeter accuracy with negligible systematic bias, but the phone, remarkably, edged out the professional camera setup on this rigid test object.

With accuracy established, the team enrolled three patients prospectively, each of whom had previously undergone a unilateral mastectomy and was planned for autologous reconstruction. During a preoperative clinic visit, each patient’s native breast was scanned in the upright position with the smartphone application. The resulting surface model was exported in standard tessellation language and mirrored across the midline to represent the contralateral, pre-mastectomy breast. The investigators caution that because breast tissue is deformable and position-dependent, the mirrored upright scan serves as a patient-specific shaping reference rather than an exact replica of the supine anatomy the surgeon encounters in the operating room, but it provides a tangible target that visual estimation alone cannot.

The models were printed at Duke University’s Innovation Co-Lab on a Form 3B+ stereolithography printer using Elastic 50A resin, a flexible, semi-translucent material chosen for its malleability and its ability to let surgeons partially see through the template intraoperatively. Each print was oriented with its concave inner surface facing the build platform to avoid the cupping effect inherent to bottom-up stereolithography and to keep support material away from the functional outer surface. After support removal, the prints were washed in isopropyl alcohol, post-cured under ultraviolet light, and sterilized using the institution’s standard operating-room autoclave protocol, making them fully surgical instruments.

In the operating room, the templates served as physical guides for flap shaping. Two of the patients underwent unilateral reconstruction with bipedicled deep inferior epigastric perforator flaps, in which the entire abdominal flap was folded ninety degrees so that lateral tissue formed the superior breast border while contralateral tissue was de-epithelialized and folded beneath to provide lower-pole projection. The third patient underwent prophylactic mastectomy of the remaining breast followed by bilateral reconstruction with profunda artery perforator flaps, each shaped into a cone to maximize projection. In every case, the sterilized template was placed over the shaped flap to approximate symmetry with the native breast and to help the surgeon visualize the breast footprint and overall contour.

One particularly notable case demonstrated a capability that earlier single-use molds lacked: reusability. In a patient whose flap provided less tissue than the template represented, the mold still guided shaping despite the limited volume, and after the initial operation the same template was re-sterilized and used during a revision procedure to guide implant placement beneath the flap and improve projection. This adaptability addresses a recognized limitation of prior rigid, single-use molds and suggests the templates can follow a patient across the full reconstructive course. The authors note that when available tissue falls short of the template, the approach can be adapted through stacked flaps or hybrid techniques combining autologous tissue with implants, and that superficial wound-healing complications observed in one case were considered unrelated to the template workflow.

The researchers are careful to frame the study as a demonstration of technical feasibility rather than proven clinical benefit. With only three patients, the series cannot establish improvements in operative efficiency, symmetry, or patient-reported outcomes, and results were limited to subjective surgeon and patient satisfaction. The authors call for larger prospective studies incorporating blinded assessment against conventional visual judgment, operative and flap-shaping time, objective measurements of breast volume, shape, footprint, and postoperative symmetry, and validated patient-reported measures such as BREAST-Q scores. They also acknowledge that while smartphone capture eliminates the cost and radiation of CT-based workflows, the printing infrastructure itself remains an institutional investment, and the collection and storage of patient surface images raises privacy and regulatory considerations that must be managed within appropriate legal safeguards.

Nevertheless, the study points toward a democratization of surgical planning technology that could extend well beyond breast reconstruction. Three-dimensional printing has already transformed craniomaxillofacial surgery, prosthetics, surgical training, and patient education, and the authors anticipate a parallel emergence of soft-tissue applications as the technology matures. If subsequent studies confirm that a device carried in millions of pockets can capture anatomy with sub-millimeter fidelity and translate it into a sterilized operating-room tool at minimal incremental cost, the print-to-patient paradigm could reshape how reconstructive surgeons plan, practice, and personalize some of the most intricate operations in medicine, turning an everyday smartphone into an instrument of surgical precision.

Subject of Research: A smartphone-based 3D printing workflow for creating patient-specific intraoperative templates in autologous breast reconstruction.

Article Title: Print-to-patient: a novel 3D printing technique for autologous breast reconstruction

Article References: Morris, M. X., Barrow, B. E., Park, H. S., Rames, J., Haider, M., Feaster, J., Sekhar, S., Rattey, I., & Phillips, B. T. (2026). Print-to-patient: a novel 3D printing technique for autologous breast reconstruction. BMC Plastic and Reconstructive Surgery, 2(1), Article 25. https://doi.org/10.1186/s44452-026-00037-5

Image Credits: AI Generated

DOI: 10.1186/s44452-026-00037-5

Keywords: 3D printing, breast reconstruction, autologous reconstruction, DIEP flap, smartphone 3D scanning, surgical templates, plastic surgery, microsurgery, 3D imaging, surgical innovation, patient-specific modeling, reconstructive surgery