Contemporary Body piercing procedures

Permanent body piercings (as opposed to play piercings) are performed by creating an opening in the body using a sharp object through the area to be pierced. This can either be done by cutting an opening using a needle (usually a hollow medical needle) or scalpel or by removing tissue, either with a scalpel or a dermal punch.

Contemporary body piercing studios generally take numerous precautions to protect the health of the person being pierced and the piercer. Tools and jewelry are sterilized in autoclaves and non-autoclavable surfaces are cleaned with disinfectant agents on a regular basis and between clients. Sterile, single use gloves are worn by the piercer to protect both the piercer and the client. Commonly, a piercer will use multiple pairs of gloves per client, often one pair for each step of setup to avoid cross contamination. For example, after a piercer has cleaned the area to be pierced on a client, the piercer may change gloves to avoid recontaminating the area with the gloves he/she used to clean it.Surgical stainless steel and titanium are ideal materials for initial jewelry in a fresh piercing.

There are many myths and misconceptions surrounding appropriate material for an initial piercing. For example, there is a widespread belief that "solid 14 karat or higher white or yellow gold containing no nickel is safe as initial jewelry (in a fresh piercing) ”. However, the common alternatives for nickel (copper, silver) in the alloy pose equal or greater risk compared to nickel. Also, gold is a soft metal, making it prone to dents and scratches which can irritate piercings and harbor bacteria.

Standard needle method

The standard method in the United States involves making an opening using a hollow medical needle. The needle is inserted into the body part being pierced. While the needle is still in the body, the initial jewelry to be worn in the piercing is pushed through the opening, following the back of the needle. Piercing using hollow medical needles does not actually remove any flesh—the method cuts a "C" shaped slit and holds it open in the shape of the cross section of the needle: in this case, a circle. In this method, the needle is the same gauge (or sometimes larger as with cartilage piercings) than the initial jewelry to be worn. Piercings that penetrate cartilage are often pierced one or two gauges larger than the jewelry, to reduce pressure on the healing piercing, allowing for a fistula (internal "skin tube" that connects the two ends of the piercing) to properly form.

Indwelling cannula method

Many European (and other) piercers use a needle containing a cannula (hollow plastic tube placed at the end of the needle, also see catheter). Procedure is identical to the standard method, only that the initial jewelry is inserted into the back of the cannula and the cannula and the jewelry are then pulled through the piercing. This method reduces the chance of the jewelry slipping during the insertion procedure, and also protects the fresh piercing from possible irritation from external threading (if used) during initial insertion.

Dermal punching

In this method, a dermal punch is used to remove a circular area of tissue, into which jewelry is placed. This method is usually used to remove both skin and cartilage in upper ear piercings, where cartilage must be removed to relieve pressure on the piercing to ensure proper healing and long-term viability of the piercing. Healed fistulas created or enlarged using dermal punches will shrink over time, but at a much slower rate than 'dead stretched' fistulas.

Piercing guns

Piercing guns are commonly used in retail settings to perform ear piercings. They work by blunt force trauma due to the fact that the needle used is normally dull and are designed for piercing the ear only. In many states it is against the law to pierce the cartilage with the piercing gun because of the damage the device can do to the tissue. The sheer blunt force of the piercing gun shatters the surrounding cartilage from the entry point of the jewellery and over time can cause the whole ear to deform, commonly known as 'cauliflowering'. Piercing guns have also been found to be a less sterile way of piercing due to the limited cleaning quality of the plastic the gun is usually made of. Piercing with a piercing gun causes microsprays of plasma and blood, which are then unable to be cleaned in an autoclave system.

Many professional body piercers discourage the use of these instruments. The autoclaving of piercing guns is usually impossible, because certain materials used in their construction would be destroyed if autoclaved. Even though they are occasionally used for other purposes, ear piercing instruments are designed and advertised for ear piercing only.

Internally threaded jewelry

A number of piercing shops exclusively use jewelry that is internally threaded. That is, the ball-ends of the jewelry screw into the bar, rather than the bar screwing into the ball. Though more expensive and difficult to produce than externally threaded jewelry, piercers who use internally threaded jewelry advise that since the bar that is being inserted into the skin has no sharp threads on the end, it will not cut or irritate skin; this allows for safer healing.

However, in today's world of body piercing, most manufacturers of quality body jewelry agree that if externally threaded jewelry is going to be used, it must have a tapered end on it so that at the very least, the threads can slip into the back end of the needle, thus protecting the piercee's tissue from being threaded during the initial piercing.

Arguments have arisen that using internally threaded jewelry can be just as, if not more, dangerous for the body on occasion. For example, if one gets one's tongue pierced with an internally threaded barbell and the threading is not properly screwed down by the piercer or becomes loose because of playing with the jewelry, one runs the risk of swallowing a ball. Whereas an externally threaded ball would simply pass through the body (because it has nothing protruding from it), an internally threaded ball would scrape the throat, stomach, and intestines with its threads as it passes through. However, this risk is only evident with oral and, rarely, nasal piercings.