The use of video- assisted endoscopic surgery is widespread in many areas of medicine. For example, very few gallbladders are removed the "old fashioned" way through large incisions. Large incisions in the abdomen can be avoided with more minimally invasive techniques. We are now applying these techniques to cosmetic surgery to allow us to place scars in more favorable locations. In the past, breast implants usually meant scars on the breasts themselves. Now, some plastic surgeons are placing breast implants in the usual position (i.e., under the pectoralis muscle) through small incisions in the axillae, thereby avoiding any scars on the breasts. Because the endoscope provides such an excellent view, placement of the implant can be very accurate and can occur with minimal bleeding even though the incisions are in the armpit areas. The two photos on the left show postoperative results from a recent patient of mine using this technique, compared with preoperative views on the right.