Circumferential scalp reduction combined with a suture-in-place Silastic-Dacron extender is an extremely viable method to treat patients with extensive baldness. The decrease in slot formation and minimal stretch-back afforded by circumferential scalp reduction and the shortened 1-month time interval between surgeries brought about by the Silastic-Dacron extender make this a procedure that hair replacement surgeons should have in their armamentarium.