Let T be a complete o-minimal extension of the theory of real closed fields. We characterize the convex hulls of elementary substructures of models of T and show that the residue field of such a convex hull has a natural expansion to a model of T. We give a quantifier elimination relative to T for the theory of pairs (R, V) where $\mathscr{R} \models T$ and V ≠ R is the convex hull of an elementary substructure of R. We deduce (...) that the theory of such pairs is complete and weakly o-minimal. We also give a quantifier elimination relative to T for the theory of pairs (R, N) with R a model of T and N a proper elementary substructure that is Dedekind complete in R. We deduce that the theory of such "tame" pairs is complete. (shrink)