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一開始的切口是用15號或12號手術刀開的。
通常會從隆起區最後一顆牙的邊緣開始，
作為遠心楔形手術程序的延伸。
持續的使用扇形、反斜、部份後翻的切口，
做出薄的部份後翻辦片（圖7-5B）。

手術刀應持續保持在齒槽的垂直高度上。
這樣可避免不必要的碰觸或切到上顎動脈。

通常組織很厚、成球根狀或組織擴大的時候，
很難或者根本不可能第一次切口就能切入骨頭。
切口必須隨著組織與底下骨頭地形的輪廓來進行。

【原文】

The primary incision is made with a no. 15 (usually) or no. 12 (if access is
limited) scalpel blade. It is usually begun at the margin of the last tooth
in the tuberosity area as an extension of the distal wedge procedure. It is
continued forward, using a scalloped, inverse-beveled, partial-thickness
incision to create a thin partial-thickness flap (Figure7-5B')
  The blade of the scalpel should always be kept on the vertical height of
the alveolus. This prevents unnecessary involvement or cutting of the palatal
artery.
  When the tissue is thick, bulbous, or enlarged, it is often difficult, if
not impossible, to make this first incision all the way down to the bone. The
incision will have to follow the contour of both the tissue and underlying
osseous topography.