At A Glance
Author	Kris
Contact	Kris@bme.anon
When	A month ago
Artist	me
Studio	my house
Location	Tucson, AZ

Background

In the Fall of 1996 I pierced my tongue on the right side with a safety pin. That's a very wrong way to do a piercing. A safety pin is way too dull, so I ended up pushing for a long time to get all the way through, and then of course the hole was very tiny. And it hurt quite a bit. At least I was smart enough to flame sterilize everything. You can still see the carbon residue on the safety pin in the photo below. I'd been fascinated with tongue piercing since 5th grade and since my parents refused to let me pierce my ear, I guess that was my way of rebelling.

Because I had no access to proper jewelry, I wore a paper clip with bent ends in the hole while it swelled and then healed. After healing, I wore a stud earring with a longer post soldered onto it (yeah, solder with lead. I'd read about the effects of lead poisoning and none of them really bothered me, so I did it. I never did have any of those symptoms). Later that Winter I pierced the left side the same way. My parents found out about the piercings late that Spring and made me remove them.

I'd planned to pierce my tongue again when I moved out and started college, but my motivation lagged and I just never got around to it. The Summer and Fall of 2005 saw some major changes in my life. Part of that was wanting to pierce my tongue again.

Since I'd done it myself the first two times, I wasn't afraid to do the piercings myself. I seriously considered going to a shop, but doing it yourself (properly) requires so much more research and involvement that it makes the process a lot more meaningful. Plus, I was very picky about exactly how I wanted it done.

Planning

I wanted side by side piercings again (aka, "venoms" or "viper bites"), but I wanted them a lot closer towards the center, both for aesthetic reasons and to minimize the risk of tooth chipping. This created an interesting conflict since the major nerves and blood veins and vessels of the tongue are located on the underside of the tongue on each side of the tongue's centerline. I decided to attempt angled piercings. They would be side by side on top, but would both angle inward with one going forward and the other going back, and be centered one in front of the other on the bottom.

By this time I had figured out that a safety pin is not the proper tool for the job. I found numerous places online that sell pre-sterilized piercing needles. 14 gauge is the size most commonly used for new tongue piercings and that seemed like a good size for mine. However, the idea of coring out a 1.6mm chunk of my tongue really grossed me out. My first piercings had healed very nicely and wanted to make sure that these would too if I ever had to remove them. I've since been informed that a piercing needle does not really "core out" flesh at all, but rather cuts a crescent shaped slit and pushes the flesh from the center off to the side. I'm not sure that's true, but it's definitely something I'll look into further for future piercings.

What I ended up deciding on was to pierce with an 18 gauge needle, then immediately stretch to 16 gauge for the swelling process. After all swelling was gone, I would stretch to 14 gauge and install the 'finished' jewelry. I spoke with a piercer regarding this plan. She thought it was largely unnecessary and would just make the process more painful, but didn't see anything wrong with doing it that way if it made me more comfortable. I decided to try my method.

Risk Analysis

Before doing the piercing I did some fairly thorough research into the risks. I'd heard reports of brain infections caused by tongue piercing, and that's something I definitely wanted to avoid. It turns out that those reports were all based on a single case study, "Cerebellar Brain Abscess Associated with Tongue Piercing" by R. Martinello and E. Cooney. I spoke briefly with Dr. Martinello via email and he confirmed that this was an isolated occurrence and stated his opinion that the actual risk of brain abscess due to tongue piercing is likely very low.

Just thinking about how many people have tongue piercings and how few (ie, one) have had brain abscesses as a result, I definitely agree that this risk is negligible. The subject of the case report had removed his jewelry when the piercing became infected. His tongue healed, but a few months later the abscess (a puss-filled infection) developed. I decided that if there was any sign of infection in my piercings then I would see a doctor and definitely not remove the jewelry unless directed to.

The other "scary" risk that opponents of body piercing blather about is endocarditis, bacterial infection of the heart valves. I was able to find a handful of articles in scientific journals regarding this issue, but there seemed to be only two actual case reports of endocarditis related to tongue piercing. Both subjects had pre-existing valvular heart disease. It appears that this complication can result from any piercing, even a standard ear piercing, and could be a risk of oral surgery if an antibiotic prophylaxis (an antibiotic proscribed as a preventative measure against infection) is not used.

Again, even a handful of cases out of the many tongue piercings that have been done would make this risk statistically insignificant. However, it is a very scary risk, and there is always the slight chance that you may have an undiagnosed heart condition that puts you at risk. Endocarditis can necessitate heart transplant and a lifetime of immuno-suppressant drugs. Requesting a prophylaxis from a doctor prior to tongue piercing is probably a good idea.

I wasn't worried enough to do this, but ended up getting one anyway, and I'm definitely going to continue sterilizing jewelry prior to putting it in my tongue. I'm not sure how thoroughly the tongue really heals, and there's always the chance of internal tearing when removing and inserting jewelry.

Another risk is simply that of infection. There can be infection of the piercing site, or infections elsewhere, such as the floor of the mouth (Ludwig's Angina). There is at least one case report of upper respiratory compromise after tongue piercing. I was unable to find the text of this report, and the author did not respond to my email, but it appears that basically what happened is that the subject developed an infection and the associated swelling caused difficulty breathing. Again, this appears to be an isolated incident. I was not worried about this risk, but it confirmed to me that in the event of infection, seeing a doctor is definitely the proper course of action. For those interested, the report is "Serious Complication of Tongue Piercing" by I.J. Keogh and G. O'Leary.

And finally, of course, there are risks associated with the fact that tongue piercing involves installing a piece of steel in your mouth. I found reports of what is essentially abrasion of the gums and teeth, and chipping of teeth. This risk seems much more varied however. Tooth chipping may be largely confined to individuals who develop bad habits of chewing or playing with their jewelry. It is also quite dependent upon the location of the piercing. Piercings towards the tip or sides of the tongue clearly present more risk.

I'd already decided that I wanted my piercings closer towards the center. Determining the exact location was a balance between the desire to have the piercings visible/useful (you know what for) and the need to keep them away from my teeth. Ultimately, I was satisfied with the locations I selected, thought the jewelry does contact my teeth occasionally. Using acrylic jewelry can help minimize this risk as well.

Preparation

One thing I knew from past experience is that I really don't like having large jewelry in my tongue. I really liked using paper clips for the healing process because they can be continually shortened as the swelling subsides. I decided to do something similar for these piercings. I would use a pre-sterilized 18 gauge piercing needle ($2 on ebay), and then insert some pieces of 16 gauge wire for healing. I briefly researched toxicity of steel, copper and aluminum, but determined that there were no significant risks from what I was planning to do and decided to proceed. This is when I learned more about gauges than I ever wanted to know.

There are at least 5 different gauge systems out there. The piercing gauges follow the same system as electrical wire sizes (American Wire Gauge). The rough conversions are, #18 = 1.0mm, #16 = 1.3mm, #14 = 1.6mm, #12 = 2.0mm, etc. I bought steel hangar wire, aluminum hangar wire, and copper hangar wire of various gauges. None of them were actually 1.3mm. A large paper clip is 1.1mm, and that was actually closer than any of the wire I had bought. I kept looking for something better, and ended up finding a plastic coated paper clip that was almost exactly 1.3mm in diameter. I only had one, but when I straightened it out it was long enough to do both piercings.

Unfortunately, this interfered with my plan to use heat sterilization. I'd researched sterilization a bit, and it seemed that the easiest method that would produce the most sterile result was heat sterilization, putting everything in my kitchen oven for four hours on the highest setting. But, with plastic coated paper clips I needed another option. I did a little more research and selected alcohol sterilization. I was surprised to learn that there are infectious agents that alcohol is very bad at killing. However, my research led me to the conclusion that soaking something in 70% isopropyl alcohol (rubbing alcohol from the grocery store) for eighteen hours will sterilize it to an acceptable level. This method is sometimes used to sterilize instruments prior to surgery on research animals.

Once it is sterile, an object being used for surgery can be re-sterilized between procedures by soaking in alcohol for thirty seconds. This is because the pathogens that require eighteen hours to kill are unlikely to be encountered during surgery. The only object that I would need to re-sterilize is the piercing needle, since I was doing two piercings with one needle.

I prepared the paper clip pieces by bending one end of each into a spiral so there would be no exposed tip. I sharpened the other end slightly since these would be used for stretching from 18 to 16 gauge. I also stripped the paper from a twist-tie so that I could use that to clean out the piercing needle between piercings. I had a rubber cork and some needle nosed pliers for bending the paper clips once they were through my tongue. All this went into the rubbing alcohol about 24 hours prior to the procedure.

I had read about using vitamin E oil as a lubricant, and decided to try that. Looking back on it, I should have done more research into what was actually in that oil. I just assumed that since some piercing shops were using it that it should be ok. It probably was fine, but in retrospect I think I should have checked it out for myself.

For mouth wash, I bought the generic brand of yellowish Listerine. I read somewhere that the other colors have more sugar in them and can actually promote infection. That sounds like hogwash to me, but decided to use the yellow stuff just in case.

I planned the piercing for the evening of November 24th, 2005, which was Thanksgiving. I chose this day because I could have a gigantic meal prior to piercing, and I would have a full three days before having to go back to work. Unfortunately, I got sick on Monday of that week. I went to my doctor on Wednesday morning and asked if my illness would increase the risk of infection. The doctor advised me to postpone the piercing, but said that the increased risk of infection was probably not great due to the fact that a piercing is a puncture wound. I decided to go ahead with the plan, because I'd been planning it for so long and it was a convenient time to do it.

He offered to proscribe a penicillin prophylaxis and I accepted. I began taking the penicillin that day, and also used the 800mg ibuprofen that he had proscribed for my illness. Ibuprofen is an anti-inflammatory drug, so I expected this would help with the swelling. I had actually been planning to take 600mg three times per day during the swelling period anyway.

Piercing

At around 7:30pm on the 24th I took an 800mg ibuprofen tablet. The piercing procedure took from around 7:40 to 8:15. The actual piercings were very quick since I had the proper needle. Most of this time was spent trying to bend the paper clips into comfortable positions.

I began by rinsing with antiseptic mouth wash twice, washing my hands with antibacterial soap twice, and marking my tongue. I just used a sharpie to mark with and that seemed to work ok. The marker says non-toxic on it. I couldn't think of a way to sterilize it, so it was probably either loaded with bacteria, or completely sterile depending on what the ink is made of. It seems reasonable that it could be alcohol based. After marking, I took the needle out of its package, dipped it in the vitamin E oil and began.

The right/back piercing was first. I chose that one because, being in the back, it would not be in the way when I did the second piercing. I planned to pierce from the bottom up, since the veins, vessels and nerves that I wanted to miss were closer to the bottom, but that didn't work out. The center of the tongue is a lot less firm than the sides where the muscles are. As I would begin to press the needle in it felt like the tissue was sliding around. I decided to go from the top, and that worked a lot better since the top of the piercing is in the muscle, which I could keep firm as I pierced.

I used the rubber cork on the bottom as I pushed the needle through from the top, but the needle wasn't going all the way through. The cork was kind of old and too hard for the needle to penetrate. I set it aside and used my fingers like clamps as I pushed the needle through the rest of the way. It came out almost exactly on center, just as I'd wanted.

With the needle through, I dipped a piece of the paper clip in the vitamin E oil, put the slightly sharpened tip into the butt end of the needle and pushed it through. Then I clipped off the sharpened end and began to bend a little knob into the clip using the needle nosed pliers. Doing this with the clip in my tongue was an order of magnitude harder than when the clip was loose and in my hands. There was some mild sharp pain every time the pliers would slip or I'd get too aggressive with the bending.

Having two pairs of needle nosed pliers would have been a great help, but I only have one. I ended up grabbing a pair of normal pliers too. These weren't sterilized, but I couldn't bend the clip without them. Finally I got it coiled up to my satisfaction. That had taken about 10 or 15 minutes, but I was happy with the way the clip turned out. There was about an inch between the coiled ends.

Between piercings I cleaned out the needle with the thin wire, rinsed it and let it sit in the alcohol for a minute. Nothing really came out of the needle except some saliva and a bit of blood, which supports the information I've received about piercing needles cutting a crescent shaped slit rather than "coring out" flesh. I also put the two pairs of pliers in the alcohol.

The second piercing was actually the more difficult one. This one was the left/front and since I was going from the top, I was piercing in a forward direction. It was hard to get the needle in the proper angle because the butt end hit my face unless I curved my tongue a bit. Somehow I managed it and began pushing through. When the needle was maybe halfway through I hit a point of greater resistance and more pain. I wasn't sure what this was, but remembered the difficulty I had penetrating the tougher tissue layers when I had pierced with the safety pin as a teenager and decided to just push harder.

That was a mistake. It turns out that what I was hitting was the blood vessel. When I hit it blood began oozing out around the needle. There wasn't any from the back end of the needle. The vessel isn't that big and I guess the pressure wasn't enough to actually spurt blood back into my face (which I'm happy about since that would have been a hassle to clean up). I pulled the needle out and the bleeding slowed immediately.

Blood was still pooling up on my tongue however. I swallowed it and let it re-pool a few times, but it kept bleeding. I pressed some toilet paper on my tongue for a minute or two. When I felt like the bleeding was stopped I tried to remove the toilet paper, but it was all wet and stuck to my tongue. I rinsed my tongue and it all came off. The bleeding had indeed stopped and my tongue looked and felt just like it had before I began the second piercing.

I decided to try again. This piercing was still a pain in the butt because of the bad angle, but I did manage to finish it without hitting the vessel again. The needle wobbled a little on the way through so the piercing may not be really straight (i.e., internal tissue stretched a bit). I was happy with the exit point though.

That "wobble" had happened very badly on my original safety pin piercings and everything turned out fine, so I figured that it wasn't a problem this time. The only issue is that it makes changing the jewelry a bit more difficult for the first few months. The tissue must grow back into position eventually though because this difficulty does go away. Of course it probably does mean more pain, both initially and throughout the healing/swelling.

I pushed the needle out and the second piece of paper clip through and began bending it. This one was even more of a hassle than the first but I did a satisfactory job and it was comfortable enough. Again there was about an inch between the coiled ends of the clip. To wrap things up I swished with the antiseptic mouth wash again.

Healing

I began icing my tongue immediately after I finished piercing. When I use ice I always do 15 minutes on and 15 minutes off in order to prevent tissue damage due to freezing. Crushed ice is definitely the best for icing a tongue piercing. I don't have an ice maker, but I had cubes that I smashed in a towel with a hammer. I iced my tongue until about 10:15. It was tender and sore by 10:30, but there was no measurable swelling.

I went to sleep, but set an alarm for 2am so I could take another ibuprofen. There was still very little swelling in the morning. I had some bread and leftover mashed potatoes for breakfast and then iced my tongue again for 45 minutes. I also stayed on the ibuprofen for the next three or four days at least.

By lunch time the swelling seemed even less. I had some soup and ice cream. The initial tightness around the piercings was easing up and the clips would rotate freely in their holes.

On the second night I decided that I didn't need to get up for ibuprofen in the middle of the night. I was wrong; the next morning I woke up with more pain and swelling than the day before. This was about 36 hours after the piercing. I was fairly uncomfortable that day, but much of this was probably due to the fact that I was pretty ill with a fever and body aches.

The next morning (around 60 hours after piercing) I decided to shorten the clips. I cut off the bottom of each clip, removed them through the top and reinserted them from the bottom. This way I still had the nicer original coiled ends, but now the straight ends were on top of my tongue where it would be easier to work. Bending the clips again was still an annoyance and I ended up tearing some of the plastic off.

I may have shortened them too much, but I was a lot more comfortable without all that excess length catching on my teeth and food. There was plenty of sharp pain while I was working on bending the clips, but afterwards it was just a dull ache. I had some more ice cream in lieu of crushed ice.

I was still pretty sick, but began trying to eat normally. That evening (around 72 hours after piercing) the swelling seemed to have increased, probably from all the irritation in the morning and then from trying to eat like I hadn't just pierced my tongue twice. I continued taking the ibuprofen and tried to rest.

The clips were about 0.6" long between the coils. I guessed that a 5/8" or 9/16" post would probably be the ideal healed length. I wanted the posts to be short rather than long, but the diagonal nature of my piercings makes them a little longer than normal.

Six days after piercing the pain and swelling were almost entirely gone. I found myself beginning to play with the clips a bit in my mouth and made a conscious effort to stop. Playing with a piercing is a very bad habit in general, but especially with a tongue piercing. The clips were not entirely comfortable and there were some light abrasions on the floor and roof of my mouth. One reason I found myself playing with the clips is that the abrasions and my tongue itself were itching a bit as they healed.

As the swelling subsided and my tongue started feeling normal again, I noticed some whitish discharge from the right hole, on both top and bottom. There was a little of this on the left hole too, but more from the right. There was no redness or pain, and no swelling as you would expect with an infection. I suspect this was either a normal part of the healing process, or a very mild infection that wasn't serious enough to bother me. Perhaps being on the penicillin prevented a more serious infection.

Stretching

With my tongue back to normal size I decided to order some jewelry. I bought two 5/8" barbells with 4mm balls from the same company that I'd bought the piercing needle from. I chose the 5/8" posts because that seemed about the right length considering that my piercings are a bit longer than most but that I wanted to minimize excess length in my mouth.

The barbells arrived on December 6th. After having so much trouble with wire sizes I was anxious to measure them. They were 1.6mm, just like the AWG system says 14 gauge should be. Next I cut a short piece of bare 14 gauge copper wire and filed the end to a gradual tip to use for the stretching. Since I already had the 16 gauge hole, I left the tip fairly blunt. I was also careful to wash all the copper filings off; I didn't want any of those inside my tongue.

At this point I should have stopped and sterilized everything in alcohol for 18 hours. However, I'd been waiting for these barbells for almost a week and I was quite anxious to get the paper clips out. With some of the plastic pulled off the clips they weren't very comfortable and were getting quite annoying. I decided to just wash everything well with anti-bacterial soap and proceed. That was another risk, but it turned out ok and I did not get an infection.

I proceeded to straighten and remove the first paper clip. I did the right/back first since the small butt of the clip would be less to work around than the 4mm ball if I did the front one first. Then I dipped the sharpened wire in the vitamin E and slide it through the hole. There was no pain and the wire went through with no resistance. It sure didn't feel like it was stretching the hole. When the wire was all the way through it brought a small amount of blood with it, though this piercing had not bled at all originally. I let it sit for a moment but there was no continued bleeding, perhaps because the wire was stopping up the hole. I proceeded to push the wire through and out with the barbell.

Screwing on the ball proved to be far more difficult than I had expected. With my fingers around it I could barely see what I was doing, and saliva kept getting on the ball, which would make it slick so that I dropped it and had to re-wash a few times. Finally I got it on and then dried the top and bottom balls and my fingers so I could grip them both and torque the whole assembly as much as I could. I didn't want any loose steel balls slipping down my throat or chipping my teeth while eating.

The procedure was the same for the left/front hole, though I had a bit more trouble getting the wire through this hole since it really wasn't straight. There was no blood at all from this side. There wasn't much pain and it was sharp and fleeting so I must have been poking nerves on accident. After a few attempts I finally got the barbell through and attached the ball, drying everything and giving it a good twist again.

Getting Accustomed

My immediate reaction to the jewelry was "shit this stuff is huge." I guess having two of them in there makes a difference, and I had been used to the thin paper clip ends. I was quite glad that I didn't get 5mm balls as one piercer had suggested. I just needed to get used to it though. After breakfast the next morning they were quite comfortable and I'd virtually forgotten about them.

A mild ache started about 30 minutes after putting in the barbells, so I took some ibuprofen (just 400 or 600 mg I think). The barbells were definitely a bit too short so it was either that or the irritation of the stretching that caused the ache. By the next morning the ache was gone. The barbells definitely seem too small though.

I hadn't realized how much the tongue changes size. It can be very flat when you stick it out, but when it's in your mouth it gets much thicker. I could see the balls receding into my tongue when I put my tongue in it's thickest shape. After a day or two, hemispherical indentations formed in the top of my tongue where the balls were pressing in. There was no pain at all from this and I trust my body to let me know if something is wrong, so I decided not to do anything about it. I did try some 3/4" posts later. They were about the right size when my tongue was in a thicker position, but for most of the time they were just too long, so I switched back to the 5/8" posts.

What did concern me a bit is that the jewelry hit my teeth when I licked my lips, mainly on the bottom but on the top a bit too. I had a bad habit of licking my lips all the time, but the steel balls clanking on my teeth reminded me to stop and after a week or two I quit. My lips got very chapped, but soon returned to normal.

The steel barbells weren't a problem, but they did contact my teeth fairly regularly. I've had enough dental problems that I am pretty protective of my teeth, so I decided to order some acrylic jewelry. Finding 4mm acrylic balls was nearly impossible. I contacted a handful of online suppliers but my best options ended up being with the supplier I'd made my other purchases from (Razorblade Products). My order got messed up and it ended up taking forever, but I finally did get some 4mm acrylics.

They only sent one type of 4mm ball, which must have been all they had. There were some 5mm balls in the same package that I liked better. What I wear now is the 5/8" posts with 4mm balls on the bottom and the stylish blue and white checkered 5mm balls on the top. Since I was used to 4mm balls on top, going up to 5mm wasn't that bad and I'm totally comfortable with them now.

Overall, at this point, I am very satisfied and proud of these piercings.

Suggestions

Though all ended well, there are definitely things I would have done differently. The biggest thing is probably how I did the piercings and then stretched them. At this point that seems totally unnecessary. 14 gauge really isn't that big. When I remove the barbells the holes close right up and I suspect they would do the same if I had just used the 14 gauge needle. I should have gotten over my fear of "coring out" flesh, which may not have been a justified fear anyway.

Healing on paper clips or wire really isn't worth the hassle. After my original safety pin piercings I had re-bent the paper clips almost daily to keep them very comfortable. However, I was just putting one bend in the end and leaving the tip loose which basically trashed my gums. Dealing with the extra length is probably less of an annoyance than the sharp tips and trying to re-bend the clips so often.

If I was doing these piercings again, I would use steel barbells with 4mm balls. Because the piercings are diagonal, the full inch of length on the paper clips was definitely necessary during swelling. I would use 1" posts and then switch to 3/4" after about three days and then 5/8" posts after about 10 days. I would definitely buy them online from someone like Razorblade Products since their prices are so good (around fifty cents for a standard barbell).

I'm not sure how helpful the vitamin E oil was, but it certainly didn't hurt. The biggest benefit was definitely from using a real piercing needle. That was infinitely easier to use than the safety pin I'd used before.

I would definitely recommend the ibuprofen. Even though I did two piercings at once this time, the pain and swelling were a lot less than what I remember from my original piercings.

The penicillin is also a very good idea. I'm not sure if it really made a difference for me, but not using it seems like an unnecessary risk. Unless I had another reason to visit my doctor, I would probably just talk with him on the phone, explain what I was doing and ask him to call in the penicillin or another antibiotic prophylaxis if he felt a different one would be better.

Doing these piercings myself was definitely the right thing for me. They're exactly how I wanted them, and they're much more meaningful since I put so much time and effort into them. Doing it myself also made me fully aware and in control of the risks. This was a great adventure that I would have missed if I'd gone to a shop.

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