We describe the technique, the benefits and the drawbacks of an original video-assisted thymectomy (VAT), performed through an inframammary cosmetic incision and median sternotomy in myasthenia gravis (MG) patients. This procedure is clinically valuable and cosmetically satisfactory so as to be very well accepted by patients, especially by young women. We report a review of 71 MG patients treated between 1993 and 1997. A clinical remission was obtained in 48 (80%) out of 60 patients who had been followed for at least 12 months from surgery. Fifty-three of these patients (93%) judged their cosmetic results to be excellent or good.