My paper cuts are all hand cut with a Swann Morton handle and 10A scalpel blades. I get through dozens of blades on each piece. I draw on the paper with pencil, cut out along my drawn lines and then once done, the paper gets turned over to display the clean side. This means I have to be careful to flip my drawings if necessary (especially writing!) to make sure they're not backwards on the finished product. To cut I use two scalpels, my primary one is in my right hand and this does the cutting, the other I hold in my left and just use it to hold the paper flat and steady.