Cosmetic procedure for vagus nerve stimulation

•Infection could result in the need to remove the cable, electrode and battery in the patients with vagus nerve stimulation (VNS).•To prevent an infection, we make a cosmetic procedure with differing the conventional technique.•Anchoring of cable tie-down is fixed the inside of sternocleidmastoid and back side of omohyoid muscle.•Cosmetic techniques have some advantages over routine anchoring of the tie-down for the fixed VNS electrode.