Since the description of the aesthetic units of the face by González-Ulloa, surgical attempts have been made to achieve excellent results with skin grafts, pedicled flaps, and free flaps. At our institution, we preferentially use microsurgical replacement of the aesthetic units independent of the etiology. The objective of this article is to present a retrospective review of the outcome of patients who underwent these procedures. The etiology, the choice of the procedure, and the functional and aesthetic results are assessed. We suggest the main features according to the results obtained. In this retrospective review, 43 procedures in a 5-year period are analyzed and the results reported. We conclude that the operative procedure is both technically simple and effective over the long term.