Installing and Using PostgreSQL Modules
linuxforu.com
linuxforu.com
CREATE EXTENSION hstore;
The advantages of this new command is that extensions can easily be uninstalled, installed in other schemas, and most of the problems with modules relating to database upgrades are gone.
Another advantage of using CREATE is that it is an already existing convention in PostgreSQL which means it is obvious that there may be an ALTER EXTENSION and a DROP EXTENSION (both exist). If they had called it INSTALL then it could be either UNINSTALL EXTENSION or REMOVE EXTENSION.
In summary: It is meant to be intuitive to people who are used to SQL databases.
EDIT: And yes, it does "'create'-ive" under the hood. I.e. the various CREATE commands generally insert new rows in the catalog tables (the tables that store the schema definitions and users). pg_extension is the catalog table containing the list of installed extension.
http://www.postgresql.org/docs/9.1/static/sql-createextension.html
The new way is much better than the old way.(there are many other reasons to target newer postgres as well)
But PostgreSQL lets you go in the other direction, pushing type logic closer to the actual data store. This makes data storage smarter and can with a bit of judicious footwork simplify your application code.