The cosmetic aspects of device implantation imply achieving an aesthetically pleasing surgical result. It involves concealing the cardiac implantable electronic device, avoiding unsightly scars, device bulges, and protrusion (Figure 1). Cosmetic device implantation is indicated for the extremely thin patient at risk of erosion and the young patient concerned with body image. These techniques are also important in the pediatric population, patients with burn injury, and patients after mastectomy.