I’ve had situations of customers coming in with retired piercings who want jewelry put back in. It is better to repierce, try to taper the hole open, or just tell them to pierce a different body part?? Also, is it best to repierce in the same spot or move the piercing over a little?
The decision to reopen, repierce, or move on must be determined on an individual basis, but there are certain guidelines you can follow. For starters, it is important to evaluate whether the original piercing was suitably positioned.
If poorly placed (whether open or closed): When the optimal spot is sufficiently distant from an old channel to avoid risk of the holes merging, a new piercing should usually be made. You must decline, however, if excessive scar tissue is present or the piercee is otherwise unsuited.
If properly located: Reinsertion is preferable to repiercing, so a taper should be tried when evidence of a channel is visible. If the hole is too tight or totally sealed, repiercing the same spot is the next choice. As a last resort, pierce behind existing scar tissue—if it is minimal.
Whenever reinsertion is desired and residuals of a piercing are evident, I suggest checking with a taper no matter how convinced the client is of total closure; they’re sometimes wrong. I’ve reinserted plenty of jewelry years after piercings were retired. Holes may appear quite shut though still open, and vice versa. There’s also an in-between state in which a piercing is viable but has a membrane-like film obstructing the exit.
Almost universally, fully healed ear lobe, inner labia, and Prince Albert piercings remain intact when left empty, but other placements are far more variable. Upon jewelry removal, many well-established piercings tend to shrink very quickly. The area will then generally stabilize in a month or two, and the channel is apt to permanently remain in the state it has achieved by then: smaller, or fully closed.
A healed piercing that was abandoned but did not seal entirely may excrete sebum. Try a simple test: squeeze the tissue as if attempting to push something out of the hole. If sebum comes from one or both ends, there is an excellent possibility that the channel is intact. An absence of sebum does not guarantee the piercing is gone, though.
To get a better idea of what you’re dealing with, ask some questions:
- How old was the piercing when it was retired? In general, older piercings are more apt to remain viable.
- How long has the channel been empty? If briefly, reinsertion is more likely to be successful.
- What gauge was last worn? The thicker the size, the greater the chance reinsertion is feasible.
- Was anything wrong with the piercing when jewelry was removed? Piercings have a strong tendency to seal shut if abandoned when they are irritated, weeping, infected, or have open, healing tissue.
Because micro-tears are possible, always prep (clean) the area before attempting reinsertion, though the intention is to avoid breaking skin. Regardless of the jewelry size that was last worn, I highly suggest starting with the smallest taper on hand—a 20 or 18 gauge. Apply a generous dollop of sterile water-based lubricant to the end of the tool then gently probe at the most obvious opening. If the tip doesn’t enter, try the other side.
On occasion, the taper passes almost all the way through, but gets stopped by a veneer of lifeless tissue. If you can see the tip of the tool at the exit hole through a fine, callus-like membrane, success is imminent. Support that area closely with your fingertips to advance the taper through without causing harm. Sebum can also block the passage and may get pushed out with the taper.
If the smallest tool passes through with little resistance you can try successive sizes, but be cautious not to overstretch and damage the channel. You will often need to send the client out wearing jewelry that is thinner than they had in previously—even it if is smaller than you would normally use. When this happens, advise the piercee to return in a few weeks, after any tenderness is gone and the piercing feels settled. Stretch it back up to a suitable thickness over time. This can frequently be accomplished safely on a much quicker schedule than if repiercing had taken place.
There are times when an open piercing is so contracted that excessive force would be required to get even the smallest taper through. The skin sometimes loosens if you allow the tool to remain in place for a few minutes. A warm soak or compress may also help. With extremely tight tissue, a significant amount of support is required on the exit side to successfully pass the taper through and follow it with the jewelry.
Be aware that reinsertion in a very constricted fistula can be far more painful than making a new piercing with a needle. If the aperture is too snug to insert jewelry without breaking skin or causing undue suffering, it is best to repierce, especially on tender anatomy such as nipples and genitals. Decide on the best course of action based on the tightness of the piercing, the sensitivity of the area, and the fortitude of the client.
When a hole is truly gone, you should repierce right where it was previously located if it was well positioned and excessive scar tissue is not present. Going through such areas may be a tougher push for you, and more sensitive for the piercee. On other occasions, some of the channel remains open internally and the needle flies right through, so try to be prepared for either extreme.
When you can’t repierce the original site, ordinarily you must go behind it. Unfortunately, this does not assure success because scar tissue is weaker than regular skin. It can only regain about eighty percent of the strength of unadulterated skini.
If the jewelry had been removed due to complications, before repiercing is important to attempt to determine what may have caused the problem. To avoid recurrence, decide on at least one aspect to change, such as placement, jewelry style, size, or material, and/or aftercare. When a piercing is given up under difficult circumstances, it is prudent to wait a year or more for the area to normalize before repiercing. If the tissue is too inflexible and dense, I advise using Mederma or another scar-reduction product to try to improve the condition for potential repiercing in the future.
If, following a thorough evaluation, you believe that repiercing will not result in success regardless of what you do then it is your duty to decline. Offer any alternate placements presented by the individual’s anatomy.
It is reasonable to discuss what precipitated jewelry removal and if the piercing loss was preventable, go over measures that could preclude a repeat. Clients should be informed about use of tapers for home jewelry changes, retainers that can be worn for concealment, and the non-metallic pieces that can be used when regular jewelry must be removed.
Apply these principles and use good judgment so that your patrons can achieve the best results with both reinsertions and repiercings.