The esthetic outcome of dental implants in the esthetic zone is a major treatment concern in modern dentistry, especially in single-step procedures, which unite extraction, implantation, and augmentation into one surgical intervention, and are gaining popularity. Although these procedures offer advantages concerning early soft tissue preservation, they also show a high risk of complications when careful patient selection is neglected. Thus, the aim of this article is to illustrate the complexity and limitations of immediate implant procedures using two case reports. The clinical cases and scientific data show that immediate implant placement must be divided into two different groups: single-tooth implants and multiple adjacent implants. While immediate placement of single-tooth implants often shows predictable and superior esthetic results, the immediate placement of multiple adjacent implants is far less predictable. It is important to establish whether the advantages observed in single-tooth applications are also feasible for multiple adjacent implants.