The face is exceedingly important, as it is the medium through which individuals interact with the rest of society. Reconstruction of cheek defects after trauma or surgery is a continuing challenge for surgeons who wish to reliably restore facial function and appearance. Important in aesthetic facial reconstruction are the aesthetic unit principles, by which the face can be divided in central facial units (nose, lips, eyelids) and peripheral facial units (cheeks, forehead, chin). This article summarizes established options for reconstruction of cheek defects and provides an overview of several modifications as well as tips and tricks to avoid complications and maximize aesthetic results.