Consistency of results, reliability of treatment modalities, and long-term prognosis require scientific approaches to therapeutic procedures. Reliable and unbiased information rooted in academics and research assist the health care professional use current technology to develop the best course of action to restore or enhance the best esthetic outcome for the patient. Without anticipating potential failure, any immediate success is limited to initial satisfaction while ignoring the far greater elements of a future problematic outcome. This article proposes procedures for soft and hard tissue preservation, repair, or reconstruction in esthetic implant dentistry and emphasizes that an essential prerequisite to effective esthetic therapy is the establishment of a complete and accurate diagnosis.