From microtissues to organs: the future of reconstructive surgery with organ building block-based bioprinting

Abstract Reconstructive surgery seeks to restore the aesthetic appearance and functional integrity of damaged organs and tissues. However, traditional approaches are fundamentally constrained by donor tissue scarcity and associated morbidity, highlighting the urgent need for engineered tissue substitutes. Organ building block (OBB)-based bioprinting has emerged as a promising strategy, utilizing microtissues with defined microarchitectural features as modular building units for three-dimensional bioprinting. This bottom-up approach facilitates the fabrication of personalized grafts that closely mimic the structural and functional characteristics of native tissues. In this review, we comprehensively summarize the current advances in OBB-based bioprinting technologies and their applications in reconstructive surgery, with a particular emphasis on cartilage, bone, vessels, muscle, and skin tissue reconstruction. We discuss the translational potential of this strategy, highlight key technical challenges, and propose future directions to facilitate clinical adoption. With ongoing innovation, OBB-based bioprinting holds the potential to revolutionize reconstructive surgery by enabling the production of functional, patient-specific tissue substitutes.