Patients nowadays have increasing esthetic demands. Esthetics of the soft tissues have gained more attention because of the advances in periodontology and implantology. Factors affecting soft tissue esthetics are color, appearance of the gingiva while smiling, gingival recessions and black triangles. Inflamed gingiva is characterized by a darker livid color. After initial periodontal therapy, the color returns to pale pink. Altered passive eruption, hypermobility of the upper lip or excessive vertical maxillary growth can cause a gummy smile. The treatment of choice is aimed to remove the cause of the gummy smile. Gingival recessions are described as the apical shift of the gingival margin apical from the cemento-enamel junction. There are many described techniques of covering gingival recessions with varying degrees of success. A coronally advanced flap combined with a connective tissue graft has been proven the most successful. Black triangles are present when the distance from the interproximal contact point to the alveolar bone crest is greater than 5 millimeters. The most effective treatment of black triangles is relocating the interproximal contact point apically in a restorative or prosthetic manner. Tooth extraction results in significant dimensional changes in bone and the surrounding soft tissues. Understanding those dimensional changes is important for the successful replacement of lost teeth with dental implants. Recessions around implants are a common esthetic problem. Some surgical techniques have shown to be effective in covering recessions around implants. Preserving or restoring the keratinized gingiva combined with the correct positioning of the implant are important for the prevention of recessions and black triangles around implants. Peri-implantitis is one of the most common complications regarding dental implants. Severe peri-implant lesions could result in an esthetic problem. Regenerative procedures are preferable for the surgical treatment of peri-implantitis in the esthetic zone. Minimally invasive procedures, such as the socket shield technique, have been proven useful in replacing teeth with implants in the anterior maxilla, with excellent esthetic results.