Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. Tthe necessary amounts of cartilage and skin required to achieve the right effec are removedt. In some cases, the cartilage is trimmed, shaping it into a more desirable form, and then the cartilage is puled lback with permanent sutures to secure the cartilage. In other instances, no cartilageis removedl, instead using stitches to hold the cartilage permanently in place. After sculpting the cartilage to the desired shape, sutures are applied to hold the ear in the desired position until healing is complete.

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