An outpatient surgery facility whose schedule is regularly booked and whose case volume is rising will inevitably face the question of whether to increase its surgical space to accommodate the growing business. While building new rooms onto an existing structure is a common solution among facilities of all sizes, there are a few factors that can keep surgery centers or outpatient departments from choosing that route. Adding surgical square footage to a facility without expanding its structural footprint is a comparatively rarely chosen option and can be a challenging assignment, but it is possible. Here, a panel of healthcare architects discuss where they found the space to expand in place.