The surgery is done with the patient asleep using intravenous sedation. An incision is made in the crease ("postauricular") behind the ear. The cartilage is exposed. A fold is created using sutures that fold the cartilage on itself. As these sutures are tied down, the surgeon judges the degree of correction. The placement of the sutures is adjusted to achieve just the right amount of folding and just the right degree of ear projection while avoiding any unusual crimping of the border of the ear.