Surgical procedures.

A: The implantation of the cultured auricle (white arrow) took place on the right side of the abdomen above the panniculus carnosus in a skin flap measuring 150×80 mm. A silicon foil was sewn onto the abdominal fascia to prevent neovascularization from the abdominal wall. Saphenous artery and greater saphenous vein were distally anastomosed turned in the cranial direction and attached below the abdominal skin flap. *indicates the original position of A. saphena and V. saphena magna. B: Four-sided flap excision. To proof the ability of the neovascularized cultivated 3D cartilage cell construct (black arrow) to survive solely perfused by the newly implanted axial vascular pedicle the abdominal flap was excised four-sided, leaving the vascular pedicle (white arrow) intact. C: Macroscopic view after free microsurgical transplantation. Healed skin flap three weeks after free microsurgical transplantation. Black arrow indicates the integrated neovascularized cultured auricle. Scale bars = 5 cm.