Recently a St. Louis plastic surgeon made headlines not for excellence in surgical techniques or patient care, but for a huge breach of patient confidentiality. It is customary for plastic surgeons to take photos of the patient before and after a procedure such as breast augmentation and/or breast lift. This is to provide the surgeon and patient with a visual representation of what required improvement and how much aesthetic improvement was achieved post operatively. The standard operating procedure for a plastic surgeon is to keep the photos confidential in the patient’s chart unless the patient gives his/her express consent to use the images anonymously in either photo books in the physician’s office and/or on the physician’s internet photo gallery. Additionally, the photos taken and cropped so that neither the patient’s face or any identifying information is visible. Several St. Louis breast augmentation patients who provided consent for use of their photos learned that their before and after photos were not only the Internet, but were posted on the physicians’ internet site with their full names visible to the world. In fact, performing a Google search of the patient’s names yielded the images. Though unintentional, this is an extreme example of breaching patient confidentiality and it is understandable for patients considering breast augmentation or any other form of plastic surgery would be concerned. Patients of The Eisemann Plastic Surgery Center in Houston may rest assured that all medical data and photos will be held in the strictest confidence and according to the rule of law. Patient photos, if they choose to release them for a photo book or internet photo gallery, will never have information identifying them.