The authors of this editorial have been in the space of “3D printing in medicine” for more than two decades. The applications ranged from patient-specific anatomical models, surgical guides and implants. Our philosophy is built on expected changes in the processes of surgical treatment of patients using models, guides and implants. Mass production of standard implants and the system of their distribution result in a dilemma to be tackled by surgeons on a daily basis: how to apply standard implants to a specific clinical case? How to do with what is available, with what a healthcare system can afford? In our interdisciplinary team we address two challenges. Challenge No.1: Transform the surgical forethought paradigm: change from “the same implant fits all” to patient-specific medical devices. Challenge No.2: Manufacture patient-specific implants cost-effective to patients and national health care systems in terms of expense and supply. Arising with changeover from the business case of mass fabrication and supply chain of standard manufactured goods towards implants’ mass customization. 3D printing of anatomical models, patient-specific implants and surgical guides is not the challenge. Design and Manufacturing of those products is already in place in our team and many other interdisciplinary groups around the world. 3D printing in medicine community need to collaborate nationally and internationally to develop concepts of mass customization of implants and special surgery instruments to make them affordable to patients and national health care systems in terms of price and time of delivery. However, it is important to mention that, despite significant and exciting developments, there are many substantial challenges and barriers including technological and regulatory challenges.