This paper presents techniques to enhance the aesthetic results of conservative breast surgery. A number of methods are described to improve results of conservative surgery by limiting deformity, reducing scars and by immediate replacement of tissue. By application of the appropriate technique breast tumours may be excised from any quadrant in a large or small breast with a good cosmetic outcome. Attention to detail with pre-operative planning of the estimated tissue loss, placement of incisions, fish-tailing of quadrantectomy scars, utilization of reduction mammoplasty incisions and immediate replacement of defects after wide excision are useful in obtaining good aesthetic results.