The operation is usually performed with local anaesthesia and sedation. The incisions are made inside the hair line wherever possible but the hair is not cut before the operation. The hair, though, should be shampooed thoroughly before entering the hospital. Infrequently there may be some thinning of the hair for a short distance on each side of the incision line. If this occurs, the thin area can be covered by combing the adjacent hair over it. The site of the incisions will be discussed during the preoperative visit. There is little pain and discomfort following the operation. Remember that the swelling and discolourations are temporary, as are minor changes in the configuration of the hair line which may occur and are usually unnoticed by the observers or even by the patients.

There may be some areas of numbness particularly around the ear which improve to a great extent within three to six months. Some patches of numbness may persist indefinitely.

Closing of the incisions is performed in such a manner as to exert no tension on the lines in front of the ear, where the scars are usually inconspicuous without makeup. The tension resulting from the stretched and lifted tissue is thus distributed to the areas behind the ear and the back of the ear skirting the hair line. These scars are therefore destined to be more visible and have to be camouflaged by combing the hair. At times, they may require a small adjustment under local freezing eight to twelve months after.