Scalp extension involves the continuous nonvolumetric expansion of the hair-bearin scalp, viabiologic creep, using implanted surgical device. This device consists of cutting a 5cm wide strip of plain silastic (0.02 inch thick) from a larger 16×8 inch sheet, then gluig dacron-reinforced silastic strip (5×1 cm, 0.015 inch thick) to the distal ends. A stainless steel plate from hooks is then secured to each end of the extender.
 During the period from March 1996 to September 1997, 21 patients including 16 patients of male pattern baldness were treated for alopecia of the scarp using internal scalp extender in the department of platic surgery Korea university hospital. All cases were successfully reconstructed without major complications.
 It not only reduces the number of scalp reductions and time necessayr to totally excise bald vertex scalp, but also appears to decrease the amount of stretch back and atrophic scarring that may accompany some reductions. Scalp extension appears to be a useful adjunctive technique in hair replacement and reconstructive surgery, and has distinct advantages over standard scalp reduction and tissue expansion techniques.