For over a century, discussion on the management of nasal dorsum has been a struggle between the techniques of resection and preservation. This is because, each technique has its advantages and disadvantages, with the Joseph technique dominating over the past 30 years despite its surgical stigmas. The dorsum preservation techniques offers a good option for the treatment of nasal hump but like resective techniques it has its drawbacks. This may be the reason why preservation techniques withered but are now making a resurgence. The aim of this article is to describe how to avoid the aesthetic drawbacks of this technique depending on the selected approach.