A surgical approach for the treatment of cicatricial alopecia may be considered when the causal component has resolved and hair replacement is desired. Traditional procedures have been limited to scalp reduction and hair transplantation. The advent of expandable silicone implants under adjacent normal hair-bearing skin for the creation of scalp flaps offers another approach for scalp reconstruction. Tissue-expansion augmented scalp reduction of cicatricial alopecia is a surgical procedure for some patients who might not otherwise be candidates for surgical hair replacement.