Treatment involving oral implants has established a high success rate, including implant survival on a long-term basis. The challenge facing the clinicians today is to achieve an optimal long-term aesthetic result. To address this challenge, the volume of the underlying hard and soft tissue must be restored either prior to or simultaneously with the implant placement. The learning objective of this article is to review the critical biologic and clinical criteria essential in achieving a predictable success in aesthetic enhancement of the implant site. The article discusses the five phases of ridge reconstruction, utilization of bone grafts (with or without membranes), and the use of membranes alone. Soft tissue management and augmentation in aesthetic and nonaesthetic regions are differentiated and presented. Surgical complications are recognized as a clinical reality, and exposure of the membranes is evaluated and discussed. Four cases are used to describe and illustrate the clinical procedure.