46 year old male with congenital lymphedema (blockage of lymph drainage in the tissues) of the genitals and lower extremity. His scrotum was massively enlarged, whereas his penis was only moderately involved. The entire skin and tissues of the scrotum were removed except for the testicles, which were not involved. A split thickness skin graft was placed on the testicles to reconstruct the scrotum. The penis was not reconstructed except for a portion on the underside near his scrotum.