Soft tissue changes were evaluated over a period of 1 year in 48 patients who required extraction of a single tooth in the anterior maxillary arch (premolar to premolar) and its replacement with an implant. The patients were randomly divided into two groups: In group A, an immediate postextraction implant was placed, and the bone-to-implant gap was filled with bovine bone mineral; in group B, the alveolar ridge preservation technique was performed after extraction, and the implant was placed 4 months later. On the day of tooth extraction (T0) and 1 year after tooth extraction (T1), the soft tissue horizontal width, mesial and distal papillary levels, midfacial gingival level, and Pink Esthetic Score were evaluated in both groups. No significant differences were observed between the groups in any of the considered parameters. Statistically significant differences were found in the soft tissue horizontal width between T0 and T1. The clinical results of the two procedures were similar and comparable over time. When evaluating the stability of the soft tissue contour, and considering the specific indications of the two techniques, it is possible to choose either an immediate implant or an alveolar ridge preservation technique with staged placement.