Combination of tissue expansion and perforator flaps broadened the reconstructive options in burn cases with wide scar contractures. We report a case of total aesthetic subunit reconstruction of the anterior abdominal skin using a pre-expanded pedicled anterolateral thigh (ALT) perforator flap in a patient with postburn contractures. Seventeen-year-old girl had a history of scalding burn to the anterior abdomen, resulting in tight contractures inhibiting her mobility. After an expansion period of 6 months, the flap of 27 x 30 cm was elevated at the suprafascial plane and tunneled to the anterior abdomen. The flap was used to resurface the defect from xyphoid process down to the mons pubis and bilaterally at linea semilunaris. Postoperative course was uneventful. A good quality aesthetic and functional reconstruction was achieved at the 10-year follow-up. Pre-expanded pedicled ALT flaps may be considered as an option in extensive scarring requiring large amounts of tissue.