An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.