Extraoral cranial implant-retained prosthetic reconstructions have been proved to be highly successful. Replacement of the eyes, ears, nose, and larger areas including combined midface defects, which frequently have no other option available, has been done successfully. Burn patients and those with congenital defects are good candidates for this type of reconstruction, especially after autogenous attempts have failed. Cranial implant prosthetic reconstruction should be considered as a viable option for difficult craniofacial defects.