Ethnographic research methods are increasingly popular within the general field of Human Factors, usability, user experience and design. Through a case story from the development and design of a medical device called 3D Surgery – a decision aid to be used in surgeon-patient consultations for cosmetic breast surgery – the presentation exemplifies the value and efficiency of the use of rapid ethnography used as stand-alone method and in combination with other methods. The case study describes an iterative approach encompassing continuous adjustment of method repertoire as well as continuous adjustment of use of analytical tools through which insights into the specific context of use are built. The case study further illustrates how the pre-surgery consultation and decision making process of the patient can be analyzed, and how the knowledge acquired can be transferred into design criteria for the 3D Surgery System.