No more shoulders: Technical modification of Byars′ flaps

The repair of midshaft or more proximal hypospadias generally leads to a deficiency of ventral penile skin. Transposition of dorsal/lateral skin flaps may lead to redundant skin folds or shoulders. In most cases, redundant skin can be avoided by appropriate tailoring and positioning of the flaps. We describe a simple method to correct these folds when they are unavoidable.