Dielectric elastomer actuators for soft implants: Advances and key challenges for clinical translation

Stretchable actuators that replicate the motion of natural muscle are crucial for the development of next-generation biomedical implants. Among these, dielectric elastomer actuators (DEAs) standout due to their high compliance, energy density, and silent operation. While promising, several technical barriers currently restrict their safe and effective use as implants in the human body. This review outlines the recent technical advances and major challenges facing the clinical translation of DEAs as implantable systems. Actuator fundamentals are introduced, with a focus on topics relevant to their biomedical implementation. Reliable wireless energy transfer for long-term use is discussed, which is a crucial step to avoid inflammation. Tailored electronics must enable high voltage while ensuring safe actuation and control. Ideally based on physiological signals like the heart beat and additional signals, possibly determined with self-sensing. Specific examples of DEA-based devices for medical applications highlight how these technologies are progressing beyond proof-of-concept toward clinical relevance. Successfully addressing these remaining obstacles could unlock alternative soft implants capable of dynamic interaction with human tissue. DEAs hold the potential to reshape implantable medical technologies, provided that engineering, biomedical, and regulatory constraints can be overcome.