The most common method used in the United States to make a piercing is with a medical hollow needle. The needle makes an opening in the skin you want to have pierced but doesn't go all the way through. The jewelry then is inserted and follows the needle back. It's necessary to insert the jewelry immediately to hold the slit the needle made open. The needle method doesn't involve removing any flesh (some methods do). The opening is always made with a needle larger than the initial jewelry to be worn. This is done to reduce the pressure on the healing piercing, giving it more room to heal and allow a fistula to form.
* Piercing Guns
Piercing guns are gun-shaped devices that mechanically makes the piercing by forcing a stud through the body part. You can compare it with a stapler.
This method is often used by non-professional piercers and mostly to pierce holes in the earlobes. You should avoid this method because the piercing gun is hard to sterilize. The risk is infection and transmission of bulletproof pathogens.
* Cannula Method
The cannula method is similar to the standard method. The difference is that at the end of the needle there's a cannula (a hollow plastic tube) where the piercer puts in the jewelry. So at the piercing process, the cannula and the jewelry is entirely pulled through the opening. This method is often used in Europe.
* Scalpel method
When you want an opening for a large gauge body piercing, a medical scalpel can be used to make a slit. This method is often used for large gauge ear piercings. It's also used to correct an asymmetry for example if the ear piercing on one side is larger than the other because of an incorrect placement.
When you don't want your piercing anymore and you remove the jewelry, the fistula will not shrink or close from itself. The only solution there is surgically.
* Pierce and Taper
This method is for larger gauge piercings and only works on body parts where the skin is very elastic. It's similar to the standard method, but after the hole is pierced with the needle, the piercer inserts a tapered steel bar (one of larger gauge then the needle) in order to make the opening bigger. The jewelry is directly inserted, following the tapered bar.
* Dermal Punching
Piercings in the upper ear require removal of skin and cartilage to lift the pressure of the piercing and guarantee a longer viability of the piercing. Therefore, a dermal punch is used to remove a circular area of tissue, where the jewelry will be worn. Like scalpelled piercings, the healed fistulas will not shrink or close on their own.
