A deviated nose with involvement of a severely deviated cartilaginous dorsum is a particular challenge for rhinoplasty surgeons. We used a new approach for treating such cases, the “dorsal L-strut cutting and suture technique,” and assessed its efficacy and the surgical outcomes. The study population consisted of 30 patients who received the “cutting and suture technique of dorsal L-strut” through open rhinoplasty with spreader graft insertion to control a severe cartilaginous dorsal deflection and compared with another 30 patients treated with spreader graft insertion only. Preoperative and postoperative photographs were studied to evaluate outcomes. Postoperative complications were assessed. The dorsal L-strut cutting and suture technique appears to be a useful method for correcting severe cephalocaudal convexity of the dorsal L-strut in deviated noses.