Total reconstruction of the penis is a very important clinical and surgical challenge because of the multiple anatomical changes that can be found in these patients. A detailed study of all this variations is necessary in order to have satisfactory results in this type of complex reconstructions, during which microsurgical techniques are performed. Final results have to be acceptable for the surgeons and for the patients who suffered this very serious condition. This paper shows a case series performed by the authors, with good results and minimal complications. The technique is reproducible and offers a solution to a deformity associated with very important physical and psychological distress.