Better procedures and materials have enabled us to improve the results of skin expansion under knee level and extend its indications. We have used such procedures to cover defective amputation stumps in the lower extremity. When the local conditions are suitable, skin expansion permits the use of healthy skin from the lateral sides of the stump to provide coverage for the ulcerated areas, thus fulfilling the main goals which are to keep the bone shaft as long as possible and cover the stump with sensitive skin, so that a prosthesis can be fitted. In two cases, we also performed skin expansion at a distance to reduce the residual scar at the donor site (expanded flap from the other leg, expanded full-thickness skin graft) when the amount of healthy skin available around the stump was insufficient; the functional results were satisfactory. Skin expansion has become a choice strategy for this type of indication, but it must be performed perfectly to avoid complications or failures (our two first cases). It is important to take precautions at various stages of the operation which must be carefully staged.