Conventional nonsurgical endodontic treatment has a high degree of clinical success, but in certain cases surgical intervention becomes necessary. This is the case report of a patient presenting with bilaterally separate periapical lesions in the maxillary anterior region. One lesion was managed by periapical surgery using a novel and safe method of separating the soft tissue mass of the periapical lesion which was in proximity to vital and vulnerable anatomical tissues, and the other was managed by long-term intracanal medicament, emphasizing the need of application of treatment in the best interest of the patient.