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Surface Piercings 101

Although not super common, surface piercings are a really really fun addition for the dedicated piercing enthusiast. So, what is a surface piercing? What kind of jewellery do they use? Where can I have one? Surface piercings definitely garner a lot of attention, and plenty of questions! Here we will endevour to give a solid overview of the concept, and give you enough information to make an informed decision on wether a surface piercing is right for you.

What Is A Surface Piercing?

Surface piercings are a class of piercing that includes both surface barbells and microdermals. The defining characteristic of a surface piercing is that it sits inside the skin, and does not exit the back of the tissue like a traditional piercing does. It is held in place either by a baseplate (microdermals) or a long flattened barbell (surface bar) that the skin and underlying tissue heals into.

A classic placement is the cheekbone microdermal. This one has healed a treat!


Surface work is not limited in placement like ears, noses and navels! You can be much more creative with the placements and have a lot more free reign. That being said, there are some very important rules when it comes to surface work placement.

Low Movement

In order to be successful, a surface piercing must not undergo high amounts of movement. The constant rocking motions, folding and bending that come with certain placements means that your surface piercing is more likely to reject in a shorter amount of time. Areas of high movement include the eyebrows, forehead, wrists, cheeks, chest (especially on larger chested folks!) and stomach. This does not mean that the surface piercing is a definite no-go – It is important to have your desired placement assessed by a skilled piercer. For example, our apprentice Jay has a very successful forehead microdermal. This is not a placement that I would be able to get as my forehead is much too expressive and mobile! There is generally a placement that works for everyone, you just need to be particular and informed before choosing it.


The absolute priority of any surface work is safety. Every piercer should have your health as their number one goal! This means there are certain placements that are absolutely not recommended. These include the neck, inner wrists, legs, hands, feet etc. If you are thinking of an unusual placement that you have never seen before, think critically about it. There is usually a reason…


And finally, you need to take into account your lifestyle. Even if you are anatomically suited to a particular surface piercing placement, that does not mean your lifestyle will allow for it! Think about your usual daily routine – Your clothing choices, your accessories, the positions you usually spend your day in. For example, if you are thinking about chest surface piercings but spend your days behind the wheel of a car, then maybe you will need to alter the placement as seatbelts are not your friend! Or consider the ever-popular lower back microdermals. They look awesome, but if you wear jeans, belts, or spend the majority of your day sitting down, then they may not be for you. Unless you are willing to significantly alter the way you live your life in order to support a surface piercing, you’ll need to think carefully!

Appropriate Jewellery

The main issue we see with surface piercings is the use of improper jewellery. There are many styles of jewellery, only two of which are suitable for surface work. To understand this, you need to understand the basic concept of piercing healing: A piercing will only heal correctly if the jewellery enters and exits the body at a perpendicular angle to the tissue. A piercing that exits at 90 degrees to the skin will minimise pressure points, and allows the tissue to heal appropriately around the jewellery. That means that a surface bar or microdermal must exit the skin perfectly straight!

As you can see from this diagram the use of straight, curved, flexible (bioplast) and 45 degree surface barbells should be absolutely avoided! Ask your piercer what they use, and make an informed decison on wether your piercer is educated on surface work and able to perform a long-lasting, sustainable piercing for you. Here at Rogue we exclusively use ASTM F-136 Titanium microdermal plates and surface bars from Anatometal – The highest quality jewellery on the market. In addition to this, our head piercers have a combined experience of over 30 years! Our aim is to provide the highest quality service to give you the best possible result.


Aftercare for surface piercings varies greatly from standard aftercare. The main thing to note is that until the surface piercing is fully healed, it is incredibly fragile! The aim is to keep the area relatively clean whilst minimising tugging, pushing, pulling and lifting motions. We recommend cleaning the piercing once or twice a day, choosing either a sterile saline compress or a hot shower. For example, if you shower in the evenings then you will only need to actively clean the piercing using a sterile saline in the mornings!

Sterile Saline is the only thing we recommend using on your piercings. To clean your surface piercing, spray a small amount of saline onto the piercing and let the moisture soak in and soften any crusties you have underneath the top. Take a clean piece of nonwoven gauze or paper towel, and gently use it in a flossing motion underneath the top to remove any crusties. If the crusties don’t want to come away after a few seconds, do not be tempted to get rough with it! Let the crusties be. Once you have finished gently cleaning, dab the area completely dry using a dry piece of nonwoven gauze or paper towel.

Neilmed Saline Spray
Purchase Neilmed Here.Neilmed Sterile Saline Solution

In the shower, it is a simple enough process. Simply allow warm water to run over and underneath your surface piercing to gently wash away any buildup. Again, be super gentle when drying the piercing!

We recommend covering the surface piercing overnight for the first 4 weeks using a disposable plaster. This is to hold the jewellery in place while it heals, as it is quite unstable until the 4 week mark where the skin starts to repair itself. Ensure the jewellery is not touching the sticky part of the plaster! This can cause unnecessary damage to the piercing when you go to remove it.

Surface Piercing Maintenance

Surface piercings do require maintenance in order to look good and stay healthy throughout their lifespan. The main thing to keep in mind is that the piercing generally needs to be actively cleaned through it’s life as skin cells can build up underneat the jewellery top and are tricky to remove! To keep the piercing squeaky clean, the best thing to use is a dental floss pick. After you have a shower, simply take the pick, tuck the floss underneath the surface piercing top, and use it to carefully extract any buildup. As you live with your surface piercing, you will start to get familiar with how often you may need to do this. Some may need cleaning like this every few days, and some may require this more active cleaning only once a month. The most important thing to keep in mind is the less you have to manipulate or move the surface piercing, the more likely it is to last a long time!

An awesome microdermal piercing on our apprentice Jay using an Anatometal 14g threaded Gold Heart!

Surface Piercing Jewellery Options

Aside from the appropriate jewellery style, there is so much you can do with a surface piercing. The main thing to know is that surface work is always 14g/12g threaded. No threadless options here! That is due to the ever-present motion and tugging that your skin experiences that would not be easily combated by a threadless pin. So. What do you want to wear? There are so many options!

Omni or Unidirectional?

You have two choices in the initial design of your microdermal top. Do you want it to be omnidirectional – Symmetrical in all planes like a disk, dome, or circular design? Or do you want it to be unidirectional – Moons, stars, hearts, and a huge amount of other designs are unidirectional. The main difference is that unidirectional pieces much be pierced with initially, or have the threading checked to ensure that when threaded onto the post that they sit in the desired orientation. For example, if Jay wanted to swap her Anatometal Heart for another design, theres nothing to say that when she puts another asymmetrical piece on top that it won’t thread in upside down! We generally recommend circular or symmetrical pieces if you are looking to upgrade an existing microdermal to avoid this issue.

You can view all of the jewellery appropriate for microdermals here! We also love to custom order jewellery for surface work – Simply email to start the process. This way you can guarantee your absolute perfect piece – Choose from a range of thousands of designs!

Thank you for reading this weeks blog! If you want to book in for a surface piercing, click here to book your appointment.

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