There is a variety of different ways to tie on a mask dependent upon the pattern you choose to use. The most popular way has been to sew elastic onto or thread it through the mask. We have listened to feed back from people wearing masks for a prolonged period of time and to ease the pressure around the ears we have been attaching buttons to either a section of ribbon which can be worn across the back of the head and the elastic attached to the buttons or headbands with buttons sewn on and used in the same way.