A new lateral approach for implanting pacemaker generators in the chest of women and children is described. Using this technique, 83 women and 21 children were operated on with no early or late complications and with good cosmetic results up to 9 years after operation. This technique prevents formation of visible wide scars above the breast in women and prevents thinning or disruption of the chest incision in children. Ages of the women ranged from 19 to 56 years; children, 5 to 18 years. In 23 patients, this technique was used after wound complications had occurred 7 days to 3 years after use of the standard implantation technique.