Defects in the scrotal, perianal, and penile areas are problems that are difficult to repair. Methods for reconstruction of this region are limited, and none are ideal. We decided to use bilateral super thin groin island flaps for a patient with penile, scrotal, and pubic defects. A two-stage technique for scrotal sac and penile reconstruction using tissue expansion is described. A super thin groin island flap was elevated, and bilateral tissue expanders were placed. Using this, the penile, scrotal, and pubic defects were closed without difficulty. Both the aesthetic and functional aspects should be taken into consideration when covering a defect of both the testis and the penis. It is essential to have thin and durable cover for such a reconstruction. The technique described above was used to reconstruct this defect with good functional and cosmetic outcomes.