Preservation rhinoplasty is making a resurgence as a reliable method of performing primary rhinoplasty. Dorsal preservation is an important part of the approach to preserve favorable nasal contours when performing rhinoplasty. Keys to success require proper patient selection and careful execution. There are potential sequelae, such saddle nose deformity, recurrence of the dorsal convexity, cerebrospinal fluid leak, and radix step-off. This article discusses methods and adjustments in technique to help minimize these potential problems when performing dorsal preservation.