Background <p>Preservation rhinoplasty (PR) demands minimal or no resection which assures preservation of anatomic nasal components with less need to rebuild any structure. The aim of this work was to assess the assessment of aesthetic and functional outcomes of PR, emphasis on the cartilage-only dorsal preservation, defining exactly what to expect after PR and establishing clear indications for PR.</p> Methods <p>This prospective study was conducted on 20 patients, aged from 18 to 50 years old, both sexes, seeking for primary aesthetic rhinoplasty.</p> Results <p>Early postoperatively, there was minimal postoperative oedema, ecchymosis and pain. There were no encountered cases of breathing difficulty. There were no cases with late complications requiring secondary or revision procedure with high patient satisfaction rates.</p> Conclusions <p>PR should be chosen depending on the characteristics of the nose. Defining clear indications and contraindications is crucial to achieving the best results with the little effort and maximum safety. </p> <p>Level of Evidence: Level IV, risk-prognostic study.</p>