It is then placed over a stick and left to dry. The skin is now turned inside out, and any remaining flesh is scraped away. It is turned right side out again, and the slit in the back where the skull was removed is sewn together and the mouth is tied shut. Several small rocks are heated in a fire and placed into the skin. They are rolled around inside until cool, dumped, and the process is repeated until the tsantsa has shrunk too much to accommodate the stones.
Hot sand is used to continue the shrinking.
At this time the head is shaped, and a hot knife is pressed against the mouth to dry it. Throughout the shrinking process the neck must be drawn closed with a string that has been sewn through it so that it will remain proportionate to the head. The skin is rubbed throughout the process with charcoal dust, purposely darkening it so the previous owner's musiak , or avenging soul, will not be able to see out. By the time the shrinking process is finished, the tsantsa will be about the size of a man's fist. Three palm pins are placed through the lips and tied together, and red seeds are often placed under the eyelids.