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BACKGROUND Hump recurrence is one of the commonly encountered problems following dorsal preservation rhinoplasty (DP) during the learning period. OBJECTIVE The aim of this paper is to discuss different methods for the prevention and treatment of dorsal problems following dorsal preservation surgery. METHODS One hundred fifty primary rhinoplasty patients were included in our study. The noses were classified as to both hump shape (V- or S-shaped) and height. All patients had a dorsal preservation rhinoplasty with either a push-down (PD) or a let-down (LD) technique. The PD method was used for humps <4 mm and the LD for humps >4mm. Follow up evaluations were made with physical examination and photographs at 1 week, 3 months, and 12 months. RESULTS Mean follow-up was 12.68 ± 1.78 months. 78 humps were V-shaped and 72 were S-shaped. PD was used for 77 cases, LD for 83 cases. 8 patients (5.3%, 8/150) had a visible dorsal hump problem after DP surgery. Based on their preoperative hump shape, 3 cases were V-shaped and 5 were S-shaped. All recurrent cases had a preoperative hump deformity greater than 4 mm. The revision procedures were as follows: 4 patients had PD procedure, 3 had a LD procedure, and one patient was treated by classic open resection rhinoplasty. CONCLUSION We can say that there is a relatively correlation between preoperative hump height and eventual hump recurrence. The complication rate can be decreased with additional technical maneuvers and proper patient selection.