Mr. Gera uses a laser scalpel, in which there is no beam, the laser evaporates, cauterizes and sterilizes the tissue it touches. This allows the procedure to be carried out while the child is awake, without the need for a general anaesthetic.
If the traditional method of snipping with scissors is used, it is not possible to release the lip as the lip is fleshy. The lip would bleed if cut or snipped, requiring sutures. No infant would be able to tolerate this amount of treatment, so a general anaesthetic would be required. The lip is held up and either two fingers are placed under the tongue, or a tongue retractor is placed under the tongue. Most infants will cry while you do this and this facilitates the procedure as the mouth is opened for crying. Given that the baby remains still, the upper lip is released in under a minute.