Many surgeons used local infiltration anesthesia combined with a sedative, so the patient is awake but sleepy and insensitive to pain. Some patients request a general anesthesia, so they will sleep through the operation.

Sections of hair will be held away from the operative area. Hair immediately in front of the incision line may need to be trimmed but the head will not need to be shaved.

The incision is made at the level of the ears and continues across the top of the forehead at the hairline. This avoids making the forehead appear too high. If the patient is bald or balding, the surgeon may utilize a mid-scalp incision, eliminating a visible scar.

The forehead skin is elevated and measured for removal of excess tissue, skin, and muscle. The incision is closed with stitches or staples.