In most cases, the split is created through scalpeling or surgical laser. To achieve a more rounded and natural look, the upper and lower part of the cutting area in both halves are often sutured together with stitches during the healing process. This prevents sharp, unnatural looking edges on the new "tongues" which would otherwise occur.
Before splitting, some have a relatively thick tongue piercing where the base of the split is supposed to be, and wait until this is fully healed before going through the procedure, but the stretched piercing location will usually result in a visually different tissue than the sutured area.
Healing of the tongue takes approximately 1-2 weeks and during this time, the person will be unable to eat or even talk.
Tongue bifurcation is, however, not necessarily a surgical procedure. Self modifiers often choose to achieve a split by gradually tightening nylon bindings inserted through an existing tongue piercing over a long period of time. This method is long, arduous, and requires a high pain tolerance.
Tongue splitting is reversible but the reversal is even more painful than the tongue splitting procedure.