This study aims to explain our experience with dorsal preservation (DP) osteotomies, focusing on transverse, lateral, and dorsal aesthetic lines (DAL) osteotomies. We describe the utilisation of a variety of surgical instruments, including osteotomes, saws, burrs, and piezo. This paper describes our concept of transcutaneous ultrasonic osteotomy (TUO), micro-edged specific osteotomy (MESO), applying drills for lateral wall reshaping, and integrating piezo technology to establish new Dorsal Aesthetic Lines. Furthermore, we present a Radix-skull base CT series analysis to evaluate the safety of transverse and radix osteotomies.