Various techniques of soft tissue management following the immediate placement of implants into extraction sockets are evaluated; the merits of the Rehrman-plasty, the free mucosal graft, the pedicled isalnd flap, and membranes to seal the socket are discussed as are the esthetic effects of various surgical techniques used at abutment connection. Two treatment strategies are suggested. Presently, the treatment of choice seems to be to close the extraction socket after implant placement by means of either a pedicled island flap or a thin cortical bone membrane. In addition, a new excisional technique is described for use at abutment connection. If a flap has to be raised to extract the tooth, the implant should be covered by means of either a Rehrman-plasty or a cortical bone membrane. If a Rehrman-plasty is chosen, the apically repositioned flap should be used at abutment connection.