BACKGROUND: Preventing dorsal irregularities, especially in noses with high humps, is still a challenging process. Classic treatment with diced grafts may itself result in dorsal irregularities. OBJECTIVES: It was aimed to investigate the effectiveness of graft paste in preventing and correcting the dorsal irregularities. METHODS: A total of 60 patients were included in this study. While diced cartilage was used in group A, graft paste was used in group B. Hump heights and collected graft volume were recorded. To evaluate aesthetic outcomes, preoperative and postoperative ROE questionnaire and postoperative physical examination were performed. RESULTS: Although the hump height of group A (5.9 ± 1.02 mm) was greater than that of group B (5.6 ± 1.15 mm), the collected graft volume in group B was statistically higher (P <
05) (0.26 ± 0.05 cc and 0.16 ± 0.13 cc, respectively). Group B showed higher postoperative ROE scores (84.67 ± 8.9) compared to group A (80.15 ± 7.6). While the mean physical examination score for group A was 1.12 ± 0.96, this value was 0.62 ± 0.71 for group B (P <
05). None of the patients of group B had visible irregularities, but two patients of group A had. CONCLUSION: The graft paste is a safe and reliable method to prevent and treat the dorsal irregularities. The paste has a soft and cohesive structure which makes it to ideal for filling the irregularities and the dead spaces on the surface of the dorsum. Graft paste was associated with a better aesthetic outcome compared to diced cartilage. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .