We present our favorable experience with use of tissue expanders with external ports in 3 pediatric patients with giant, congenital pigmented nevi. The surgical process began at about 6 months to one year of age. One patient had an extensive nevus of the right chest wall involving the entire nipple-areolar complex. Expansion of the normal surrounding flank and chest wall skin was performed. The entire nevus was removed after two sets of operative procedures (placement of expander, expansion, then removal of expander(s) and excision of nevus). The second patient had a giant nevus over most of the upper back and central back and shoulders. He has had several series of expansions of the flank skin with great reduction in the size of the nevus. The third patient had extensive involvement of the left posterior and medial thigh with nevus. He had part of the anterior thigh and lateral thigh which were uninvolved and were used for expansion. We used 2 separate expanders with external ports which greatly minimized the trauma of the process. We had no complications (including infections) and enjoyed an atraumatic, painless expansion process which was greatly appreciated in this vulnerable patient population.