What is a Surface Piercing?

Surface piercings! Depending on who you talk to, they may have a different idea of what classifies as a surface piecing. And this is because this language has been used interchangeably for a whole host of similar piercings for a long time. However, this has led to some confusion for many clients, being unsure of what qualifies as a surface piercing and what doesn’t. So today I want to dive deeper into surface piercings, and help explain what they are and how they work.

Surface Piercings vs Surface Piercings

When we say surface piercings there are usually two primary things piercers are trying to describe with this language.

Surface Piercing- A piercing that travels along the surface of the tissue where it is pierced. Unlike piercings such as earlobes or nostrils which have a distinct front and back and are pierced through a distinct piece of tissue, surface piercings are through subtle ridges, or flat along the surface of the skin. Because of this, these piercings can be more prone to migration and rejection.

Surface Piercing- A type of piercing done just through the surface of the tissue, usually in a flat low movement place, specifically with surface style jewelry– surface bars or surface anchors aka microdermals.

So- wait, what piercings are surface piercings?

This is actually a very debated subject, so let’s look piercing by piercing.

Surface Bar- absolutely a surface piercing. This piercing goes along the surface of the skin with a staple shaped bar, allowing the tops to rest flush against the skin. Arguably, the quintessential surface piercing. These are considered long term temporary, and while some folks will have them for years and years, others may migrate and reject very early on.

Surface Anchor/Microdermal/Single point piercing- absolutely a surface piercing. This piercing sits just under the surface of the skin with a small base, and a tiny rise for threading that sits above the surface of the skin. These are considered long term temporary, and while some folks will have them for years and years, others may migrate and reject very early on.

Bridge Piercings- Here is where piercers begin to debate what classifies as a surface piercing. A bridge, done on very well suitable anatomy, has a very protrusive ridge there that we are piercing through- on some clients it does have that distinct front and back. And when someone isn’t suited for a bridge, they have no ridge there at all. Obviously, those are folks who didn’t have the anatomy to have a bridge in the first place. However, there is a grey area between perfect bridge anatomy and totally unsuitable bridge anatomy. And if I’m being honest, many of us (myself included) fall within that grey area. We have a ridge, and it’s prominent enough to be able to pierce. But it’s not a super prominent, super defined ridge. With this anatomy, clients may run a much higher risk of migration or rejection, but many folks will get pierced and heal just fine.

In these situations choosing to pierce often comes down to informed consent. Discussions between piercer and client about the anatomy, the risks including migration, rejection, and severe scarring, and what to expect from healing. But many clients decide it is worth the risk to do the piercing and many end up with happy, healthy, happy bridges. Some clients are not so fortunate and end up with scars.

It’s my personal opinion that bridge piercings on many anatomies can fall under the umbrella of surface piercing- being through a ridge that lacks the same distinct front and back of say an earlobe or a lip, and having a higher risk of migration and rejection. Because of this anatomy, and because of the way bridges react during healing, I think they can fall under this umbrella.

An example of a very prominent, ideal bridge anatomy

A bridge piercing that had to be removed due to rejection. We can see the bridge anatomy itself is shallow and wasn’t ideal for piercing to begin with.

Eyebrow Piercings- The same debate we have for the bridge, we have for the brow. Some clients have very prominent brow bones with stable, nearly shelf like ridges that are ideal to pierce. Others have a brow bone that’s virtually flat with hardly any protrusion, and not viable for piercing. And many clients fall in the grey area in-between. Enough of a ridge, enough tissue to support piercing, but not nearly the ideal amount we’d like to see.

The same discussion of informed consent comes into play here too. Discussing the pros and cons, the risks, and allowing clients with anatomy that falls somewhere between absolutely not and this is the most perfect eyebrow I’ve ever seen the agency to decide what risks to take.

And much like bridges, I think that because the anatomy can vary, because we see the same risks of migration and rejection, and the same healing reactions and irritations, I think this all combines to apply eyebrows to the category of surface piercings.

Navel Piercings- If you thought eyebrows and bridges were a grey area, navels take it a step further. All anatomy has some degree of variance, like the difference between a perfect to pierce bridge and an unpiercable one. But navels have significantly more variance than any anatomy we’ve looked at yet.

Some people have navels with a perfect, distinct ridge of tissue at the top, nearly it’s own piece. I’ve seen navels with a more distinct lip of tissue then some earlobes. There are navels that hover in-between, where they have a very distinct lip but its not it’s own separate piece. Some people have a distinct lip but it faces basically downwards. Others have a lip that’s piercable but not distinct at all. Then we get into navel shapes- from tall and skinny to wide and round to totally flat and closed. This huge variation in anatomy can make it hard to classify what navels fall under.

An example of a floating navel with a super defined easy to see ridge

But, quite a few folks have anatomy that exists on the cusp. They have a piercable ridge but because of the angle it sits at or the way their body moves, it’s more like a surface piercing in how it will rest in the tissue. Floating navel anatomy can often be a good example of this. Others have double gem navel anatomy but the lip of their navel is so thin and small, and their navel is so shallow, that it basically sits like a surface piercing as well. But they are still, viable, piercable, navels.

A client with double gem anatomy but barely any ridge or lip- this is more of a surface piercing then the first navel example

Navels can also encounter the same issues healing as other surface piercings with migration and rejection. Most notably, navels done outside the proper band of tissue and instead pierced in front of the navel are notorious for migrating and rejecting to the effect of some awful scars. These navel piercings done outside the navel band are 100% surface piercings. They are basically just the skin of your stomach pierced.

An incorrectly done navel piercing that ended up as just the surface skin of the stomach pierced.

But what about properly done navels? Personally, I think some do qualify as surface piercings. Other anatomies don’t. Putting all navel piercings under the umbrella of surface piercing or saying they aren’t surface piercings at all looses some of the nuance that this varied anatomy can present with. But, given that navels can struggle with the same issues that surface piercings have, it’s not a bad idea to air on the side of caution and treat and heal them like a surface piercing.

Migration and Rejection

While migration and rejection is possible with any body piercing, it’s significantly more of a risk with surface piercings. When we are healing a piercing we are creating a wound with a foreign object trapped inside of it. Our body doesn’t want that object there, it views it as no different then a splinter of wood. We can’t magically tell our bodies that this splinter is the good one we want to keep. So our bodies want to do what they are designed to- get the foreign body out. This is tricky for our bodies in an earlobe or a lip- it’s far easier for our bodies to push jewelry to the surface in placements like navels and eyebrows. In part because of how our bodies respond to the piercing, but in part because of the tissue the piercing is through. Navels, eyebrows, and bridges all have a fair amount of movement as we emote, express, bend and sit during the day. All of this movement can cause irritation. Many of these placements are also more likely to be caught, snagged, or bumped during the day. And again, it’s not that other piercings don’t get caught and bumped, but that combined with the fact that surface piercings aren’t through as defined a piece of anatomy, and the body wants to remove the foreign object anyway…it’s a recipe for migration and rejection. A hard snag on a helix will be uncomfortable, in some rare instances it may be enough to cause slight migration. But a very hard snag on an eyebrow can mean the end of that eyebrow piercing far easier than it would be the end of a helix.

However, all of those piercings have the benefit of stability of the tissue they are in- and all of those piercings if done well and healed well do have the potential to be permanent piercings you enjoy for a lifetime. Surface bars and anchors however, do not. These piercings are considered long term temporary. While some clients may get lucky and have them for 5, 10, or even 20 years, they do generally eventually reject. The truth is most folks only end up keeping surface piercings for 1-5 years. This is due to a lot of the same factors we see with migration and rejection on other piercings- movement, catching and snagging, and our bodies inherent desire to remove foreign objects. Beyond that, surface bars and anchors are just less forgiving. When you snag say your eyebrow piercing, there still a somewhat defined ridge of tissue holding things in place, and your snag may just irritate the channel of the piercing. But when you snag a surface anchor or bar, it’s possible to dislodge the entire base. The whole rise of a surface bar may be snagged up if you catch it hard enough, and the whole side of an anchor as well. This type of trauma for these piercings can irreparably damage the pocket that they sit in. Where as with a good snag on an eyebrow it can cause some damage to the piercing channel, but rarely the same degree as with surface piercings.

Piercings that aren’t surface piercings can sometimes deal with migration and rejection, however this is significantly more unlikely. And even when they do struggle with these issues, it tends to present differently. For example, helix piercings can often migrate when they aren’t downsized and slept on during healing. This can cause the angle of the piercing to shift from straight to diagonal. But this migration tends to come with a shift in angle and some irritation bumps. It usually isn’t coupled with the same pushing toward the surface, and distinct irritation bumps that we see from surface piercings. How many people have you known who have had helixes migrate right out of their ear? And how many navels and eyebrow and bridges do you know that have done that?

So what’s the difference between Surface Piercings and Surface Piercings

Like we discussed above, surface piercing as a term has come to refer to both any piercing through a less defined ridge of tissue and piercings that are done with surface jewelry such as surface bars and anchors. So, what’s the difference between the two? Why don’t we use surface bars for eyebrows and bridges?

This comes down to the anatomy of the tissue we are piercing through. When we are piercing, we want jewelry to be perpendicular to the tissue. When we consider the anatomy we are working with when we opt to use a surface bar- placements like the nape of the neck and the forehead vs anatomy we are working with when we pierce a bridge or an eyebrow- these are entirely different shapes and structures. Surface bars and microdermals work perfectly in flat areas of tissue like the back of the neck and below the eye where they can rest perpendicular to the skin. These are also low movement areas, which fair far better for surface bars. This is also why curved barbells and straight barbells are a bad idea for surface piercings- they aren’t perpendicular to the tissue. Eyebrows and bridges however still have a defined ridge. As we discussed above ideal anatomy for these piercings is actually such a well defined ridge it almost has a ‘shelf’ like shape, and it’s very distinct from the surrounding tissue. But as we know there’s a whole grey area between ideal anatomy and not suitable anatomy. And that’s where that tricky distinction of surface work comes in.

We also see similar issues with migration and rejection in all of these piercings. Although with anatomical variations in navels, bridges, and eyebrows, these become piercings that don’t fall into the long term temporary range. While there haven’t been any official studies done (and boy how interesting a study like this would be) if I had to estimate I would say I see migration and rejection in about 5-10% of well done navels on proper anatomy. Conversely, I see it in about 70-80% of well done surface piercings. So while migration and rejection do still happen in navels(and bridges and eyebrows), many of these piercings still end up permanent and lasting most clients a lifetime. The same unfortunately can’t be said of surface bars and anchors, and you can tell that to the 4 different forehead surface piercings I’ve gotten in my days. This is an important distinction, and part of the main difference between these piercings.

However, despite their differences, we still see lots of similarities between surface piercing and…surface piercings. They encounter similar forms of migration and rejection that other piercings rarely or never do. The way this migration presents in both surface bars and anchors as well as bridges, eyebrows, and navels is distinct and often very different from what we see when other piercings experience migration. And varieties of surface piercing experience this far more often than other piercings do.

Because of the similarities these piercings experience, I think its fair to group them in a similar category. But this does have it’s drawbacks in that clients are now asking if their navels and eyebrows are long term temporary like surface bars and anchors, and if they should be using surface bars for these piercings. This confusion is not helping anyone. I think it would be beneficial if we looked at surface piercings more like a scale and less like a category.