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Predictable esthetic management of the compromised anterior dentition with dental implants constitutes one of the most difficult challenges in contemporary dentistry, especially in scenarios where soft and hard tissue defects are present. Traditional surgical approaches will often result in peri-implant soft tissue disfigurement. Although the use of pink restorative materials has been proposed to disguise soft tissue deficits, maintenance issues and esthetic limitations remain a concern, particularly as it pertains to high smile cases. This presentation will focus on the predictable esthetic management of high-risk and compromised sites, demonstrating the use of contemporary interdisciplinary strategies for the treatment of peri-implant esthetic dilemmas and complications.