In 1998, the federal government mandated that breast reconstructions after a mastectomy be covered by health insurance. That was the last time anything really big happened in the field of breast reconstruction, and while it was a huge development, it wasn't an improvement to the procedure itself.
But an Austin company is aiming to transform outcomes for breast reconstruction patients through the use of 3D printing technology.
Warning: This story contains some frank discussions and revealing images of human anatomy.
Patty Rodgers, Debbie Rice and Gail Chovan have a few things in common: All three women fought cancer, and all three lost their breasts as a result.
"My husband and I decided that breasts were not the most important things in life,” Rodgers says.
"I remember just grieving before it began,” says Rice.
"I never had to buy a bra, and I had beautiful perfect breasts that I was really proud of," Chovan says.
The loss of their breasts was tough on the three women. But their goal was to beat cancer whatever it took – chemo, radiation, surgeries – the goal was survival.
After breast cancer, what comes next?
Once they'd fought cancer and survived, all three women began to wonder what came next. How would they become whole again? Breast cancer survivors who get mastectomies are faced with the choice of whether or not to have breast reconstruction surgery, which, thanks to the 1998 mandate, is covered by insurance.
Rodgers chose to get a reconstruction, so doctors took fat from her belly and with that, made her new breasts.
Rice had a similar procedure.
But Chovan, an Austin-based fashion designer, went a totally different route: She chose not to get new breasts. Chovan and her post-surgery body are featured (skip to 7:24) in the video below.
"Nobody gave me the right answer, and my oncologist finally said, ‘No matter what they do to you, you are going to constantly look at it, and you are not going to be happy because you want it to be the way it was, and it's never going to be the way it was,’" Chovan says.
A feeling that something's missing
Chovan's doctor was right – after reconstruction, many survivors say they are constantly reminded of how lucky they are to be alive. And while these women say they are grateful for that, still they all have a nagging feeling that something's missing.
"I came out looking like a Barbie, because Barbie doesn't have nipples,” Rice says.
Breast reconstructions, whether made with implants or with fatty tissue, don't include nipples. Months after the initial surgery, doctors can create a little bulge by pulling up some skin and stitching it together. Then they can tattoo around the pinch to give the illusion of a nipple. But both the pinch and the tattoo often fade within a couple of years, so many choose not to bother with the nipple part of the procedure in the first place.
Rodgers tried to deal with her new nipple-less breasts with humor, she says.
"On Halloween, I even put – you know – the stick-on spider webs across my chest where your nipples should be, and aggravated my sister. I'd pull up my shirt [and say] look – and I'd have these spider webs,” she says.
A great tool and an 'ingenious idea'
Laura Bosworth, a former Fortune 500 CEO, was aware of how bothersome it is for survivors to deal with reconstructive surgery and life without nipples. But she figured there was nothing she could do about it – until she met Dr. Thomas Boland, a biomedical engineer. The two clicked.
"Well, I'm just a forward thinking kind of guy, I guess – and very innovative,” Boland says.
Boland and Bosworth talked about some work he was doing with cells. And even though Boland described his project as very tedious, still Bosworth became interested.
Boland's lab is at the University of Texas at El Paso, which happens to be Bosworth's alma mater.
"That [first project] had to do with trying to pattern cells – trying to make a blood vessel, for example,” Boland says.
It required manually drawing the pattern for the casing in which the cell would grow.
"Making patterns was very, very difficult,” he says, because he had to do a drawing for each individual cell he grew. Then one day, he looked around the lab and saw an ink jet printer.
"What if I could empty the printer's ink cartridge and instead of ink, fill it up with a protein?" thought Boland. Could he "print" the cell patterns and do away with the manual labor?
Eventually it worked, he says.
That was back in the year 2000. Then he did the same with a 3D printer.
"We started out with having a great tool – a printer – but, what are you going to do with it?," Boland says. “Then Laura had the ingenious idea of using this specifically for the nipple."
'Custom made for you'
Bosworth, Boland and others decided to start a bio-printing medical company in Austin. They called it TeVido.
TeVido specializes in "printing" nipples through 3D technology. Instead of ink cartridges, they use a person's harvested cells.
“Custom made for you,” Bosworth adds. "The intent is it would be able to match the [skin] colors exactly. Now, at first we might start with, 'Hey, here's your five color choices.' But, as we mature the technology, we could really create very good matching."
For something that came out of a printer and is made with human cells, the nipples look pretty good.
When Rice heard about the 3D-printed nipples, she said that she couldn't "get the concept of a 3D printer in my head."
"I think it's fascinating," she says. "Not have the Barbie boob syndrome!”
The technology has the potential to even help women like designer Gail Chovan – who did not get a reconstruction. Bosworth says TeVido’s process could expand to "print" an entire breast.
But for now, the 3D-printed nipples are in the early stages: Clinical trials are still about two years away.