Figure 1).

A A skin graft 8.5 cm long × 7.5 cm wide covering the excised melanoma defect on the right parietal scalp. B Five pairs of metallic foot plate anchors, which anchor into the subcutaneous tissue of the scalp, were sutured to the scalp with 4–0 nylon 5 mm from the margin of the skin graft on each side of the graft. Five silicone elastomer cords connected each of the five pairs of metallic anchors. The cords were subsequently stretched to 1.5 times their resting length, as assessed by the length markers on the cords. C Weekly visits continued with further reductions in the width of the graft. By day 130, the defect was less than 1 cm. D Wound following excision of the skin graft. The defect was closed with the newly expanded skin using 4–0 nylon. E Healed wound at day 175