Sinus membrane perforations are among the most commonly reported intraoperative complications encountered during maxillary sinus floor elevation procedures performed via the lateral window approach. Large perforations (> 10 mm) can pose a major clinical challenge, and often result in failed bone augmentation and poorer long-term implant survival. Owing to these challenges, even a highly skilled oral implant surgeon with advanced training in implantology faced with such perforations may abandon grafting procedures in favor of a reentry approach. This article describes a novel approach to managing large perforations through the use of a collagen membrane stabilized by tacks on the medial and lateral walls that is permissive to simultaneous bone augmentation.