Dorsum preservation techniques have been popularized in recent years. The nasal septum is always in the middle of all these procedures. The structural rhinoplasty surgeon should learn the principles and techniques, which are quite different from the structural techniques. To change the position of the dorsum, foundation techniques, namely push down or let down, and surface techniques are used. There are four main approaches to the nasal septum to lower the bony-cartilaginous pyramid. In the high strip technique, bony-cartilaginous resection of the hump is performed under the intact dorsum, which corresponds to the upper portion of the nasal septum. When the cartilage resection is performed 7–10 mm below the nasal dorsum, it is called as intermediate strip. Some modifications of this technique have been described in recent years, such as the segmental Tetris concept and subdorsal Z-flap techniques. In the low strip technique, the resection of the septal cartilage is done on the portion sitting on the maxillary crest.