I would theoretically support regulation for the sake of client and practitioner safety, but realistically it would be a NIGHTMARE.

It’s hard enough to find doctors that don’t panic at the first sign of a healing tattoo or piercing, let alone those who would be willing to stand up to their peers and condone body modification publicly and THEN be willing to create and support regulations for the industries.

Even if all that did happen, there are the hurdles of politicians and PTA mothers to clear, as well. Or am I being too pessimistic?

My guess is that you’re being realistic, Joy. And pessimistic or not, the politicians and PTA mothers are the hurdles that would be the hardest to clear. Well worth the effort, but still a tricky one.

The rules and regulations on tattooing have caused our industry to improve in countless ways just in the last decade. Ever tightening boundaries on what is considered safe and sane in the world of tattooing has caused those of us who tattoo for a career to improve and adapt. In my opinion, those changes have been for the good.

Long gone are the days of tattoos only being for “sailors and whores.” Don’t get me wrong, I still tattoo my fair share of both groups…but, we see a wide mix of people on a daily basis. Church ladies share a couch in the waiting room with gangster rappers while waiting for us to finish tattooing the cop. The surgeon on his day off stops in for a consult on his back piece, while the renegade biker brings his daughter for her first piercing.

And that’s not even the tip of the iceberg.

There have been many changes I’ve grumbled about over the years, but in reality, it’s the things I’ve grumbled about that have caused my chosen career to become widely accessible to all of those groups, and more. You learn to work around the ones you don’t care for…and find, for the most part, a better way.

I would support regulations if they were made with the support of people in our industry. Too often bureaucrats and health department officials write up the regulations without getting any input from someone in our field. The health inspectors that inspect studios in most places are used to inspecting restaurants. They don’t really know what they are looking for in a tattoo/piercing studio.

California right now is in the process of writing regulations. They met in a few different cities with piercers, tattoo artists, the APP was represented by Steve Joyner, and that is how I feel it should be. That way you are getting regulations that make sense.

Well said, Tracy.

The idea of regulating the things we do is a double-edged sword. On one hand, rules and guidelines set up and ENFORCED are a wonderful thing, but only when the rules and guidelines are created with input from the practitioners who are professional and on top of their game. I have worked in shops in the past that were about as dirty and unethical as it gets (this was over 10 years ago), but the owner tattooed a health board member and got to make up the rules—that is TERRIBLE. That’s why the autoclave area was also a break room.

Other cities get it right though. In Philadelphia, if I am not mistaken, shops must use internally threaded jewelry for initial piercings. They hit gold when they got Bill Funk to help write legislation.

Of course, the downside to responsible legislation is that it sometimes harnesses what we can do as far as more extreme procedures. The law tends to frown on scalpels, biopsy punches, anesthetics and the like. It’s a cross we have to bear, I suppose: Do we operate within the laws designed to protect the public from the stupidity of people who don’t know what they are doing, or do we break the law because we are responsible and know how to use the tools we aren’t supposed to be using?

If legislation were to go into effect that really, truly protected people—the outlawing of ear piercing guns, the requirement of weekly spore testing for all autoclaves and statims, mandatory bloodborne pathogen training, etc.—then that would be the right start, in my opinion.

Where I live and operate my studio, there are no regulations—other than the state law of not tattooing anyone under 18 or who is intoxicated. I’ve been open for eight years, and worked in this area for almost four years before that. In 12 years, I’ve never seen an inspector, or even heard of one inspecting any studio around here.

I would love to work with the health department or whoever, to set at least a minimum set of guidelines that all studios have to follow. Walk into most studios around here and ask them what a spore test is and when the last time they ran one was? You’ll get blank stares.

John, being in NY as well, we have NO inspections. We have to hang a sign up that says if you are unhappy or have a complaint, dial 311.

In NYC, where we are, it’s worse than the usual statewide ignorance, I think. There are sunglass vendors doing piercings at sidewalk stands for $30, jewelry included, no age limit. We hear horror stories all the time of the St. Marks piercers doing 14-year-old kids’ nipples and stuff.

Tattoo artists are required to register with the city, get a license, etc., but piercing is totally and completely unregulated. It’s terrifying.

I like to think if I were in an area with absolutely no regulations, I would run, not walk, to the powers that be and get started with some input. With a quickness.

This in NO WAY is meant to cause a fuss, or to point fingers, but it’s easier to complain about the lack of (or problems with) regulations if you have no intention of trying to be involved. Please correct me if I’m wrong, but in most cases there should be a chain of command to follow that will lead you to a meeting or an individual with whom you can voice your concerns.

I’ve contacted the health department in the past and was told there was nothing they could do because they just didn’t have the money.

I’ve even had clients tell me that they had called the health department on other studios after having work done there, and were told the exact same thing.

New York just doesn’t give a flying fig about it. They figure that the people can govern themselves, which is REALLY backwards considering that tattooing was illegal here until very recently because of the health problems associated with dirty tattooing. That’s why the licensing is in place, although from what I understand, it’s pretty useless. Our piercer at our other store has a tattooist license just so he can get wholesale pricing on piercing supplies through a few NYC–based companies.

Funding for such things is very limited here. It’s there for welfare programs and other things, but not there for the general health and welfare of people getting modified. If I was 16 and knocked up here, I’d get the best care, but if I get the hep from a dirty studio? Forget it.

NYC is a little different than the rest of the state. We don’t even have a tattoo licensing process here [in Syracuse]. Although, I have heard that the licensing process in NYC is set up more to make the city money than to actually benefit the general public.

Another big problem I’ve seen is areas that have good regulations in place don’t have the funds to enforce them. Look at Philadelphia. It has some of the best piercing regulations in the country. But, they aren’t enforced at all, and you can walk into any number of studios and get pierced with crap externally threaded jewelry, even though regulations say you can’t use that for an initial piercing.

True. Money always seems to be best put to use on other programs. Giving everyone who smokes in your city the patch for free is more important I guess.

I asked Maria about the health inspections here in NYC. In 17 years, there has never been one, but about 10 years ago, someone with a fake badge came around and demanded $100 to do an inspection.

Have any of you actually worked with the health departments in your areas?

When I lived and pierced in Madison, Wisconsin (’96-’98), I worked closely with the state when they decided to set up statewide regulations. They formed a committee of three piercers, three tattoo artists, a doctor, a public health nurse, an epidemiologist and a few other people. They had a basic template when we started and then we worked on refining the regulations. For the most part it was a pleasant and productive process. The non-practitioners were respectful of what we had to say and in many cases took what we said about our specific industries very seriously. We ended up with what I felt was a decent set of regulations. Unfortunately, I left the state before those regulations went into effect. I can’t speak to how well they are, or aren’t, enforced.

Here in Minneapolis (and they are looking at going state-wide soon), we have a set of regulations that isn’t bad. There are definitely some things that could be improved. The regulations were created before I lived here, but it is my understanding that there was input from at least a few piercers and tattoo artists. Unfortunately, those regulations include bans on branding, scarification, implants and suspension.

I have worked with the Minneapolis health department a fair amount, but they seem to be in the position that most health departments are in: they don’t have the money to do any more than the bare minimum they are required by law. We get our once-a-year inspection (which is okay, but not fantastic) and we don’t see them again unless there is some sort of complaint.

I think the key to good regulations (which I support) is having knowledgeable, ethical practitioners involved in the process from the beginning. It’s much easier to get the regulations right the first time around than it is to try and get them to go back and change things once they are in place.

In New Mexico, the laws went statewide late last year—instead of just the city of Albuquerque, like they have been for the last 10 years or so. The laws were written with piercer and tattoo artist input, and there is a piercer and tattoo artist on the board that regulates us (Board of Barbers and Cosmetologists unfortunately).

We have some decent laws, like all shops have to pierce with implant grade jewelry, for example. However, they straight-up told us that they are not going to enforce the laws or shut down any shops that refuse to comply because then they couldn’t make any money off of that shops permits, etc.

It always comes down to money. Even if they didn’t enforce the laws and just sent out a letter or something pretending that they were going to, it might help make a lot of these shops clean up their acts or close down on their own. The stupidest thing they could have done is what they did by telling us that yeah, these are the laws, but they have no intentions of enforcing them because they want to make as much money as possible—and that means giving everyone with $300 a permit even if they don’t meet any of the “qualifications” that the board has set to get a permit in the first place.

I’ve heard that same story a lot—that basically, you send you city, county, or state some money to get a certificate and that is basically it. After that, there is no real enforcement.

I think it’s great that the stories some of you have shared involve meetings with piercers and tattoo artists to set the regulations up, but it doesn’t do any good if they aren’t enforced.

I’m not trying to make excuses for health departments or health inspectors that aren’t doing their jobs. I do think it’s important, though, to keep in mind that very few of the people involved in inspecting and enforcing piercing/tattoo regulations know anything about the industries to begin with. So, not only are they being asked to take on additional inspections, and probably for no additional pay, they are also expected to further their education regarding piercing and tattooing with very little, if any, resources (i.e., time and money) being provided by their health departments. Most inspectors are trained in inspecting restaurants, nursing homes, local fairs and possibly hospitals—not piercing and tattoo studios.

Clearly, continuing education is part of any job. Imagine, though, if someone came along and told you that you needed to become familiar with how to do a manicure or a pedicure. After all, those things involve the body just like piercing and tattooing…even though you have no interest in those things. Now, not only do you have to learn that stuff, but you aren’t going to be given any time or money to do it.

I don’t think it’s hard to imagine how much time and effort any of us would put into learning about those procedures.

I’m terrified of regulation. On the plus side, it would keep some crappy shops less crappy, but I’d be concerned with the state banning procedures they don’t understand. A few years back, New Hampshire tried to ban all piercing because some councilman’s daughter got an illegal piercing. So rather than just making stricter rules, they attempted to outright ban the entire practice. I would love to see responsible regulations in place, but not if it limits what procedures can be done. In the last few years, New Hampshire has actually lessened regulation due to budget restrictions. They can’t afford to inspect shops anymore, so basically everybody works off the honor system, and you can imagine how ridiculous that gets.

I’m sure every body art worker wants reasonable regulations. I don’t think the majority of health departments are educated enough to understand what it is they’re regulating and how best to do so. The double edged sword is that it’s often one individual’s personal opinion that decides what gets a regulation and what gets a ban.

Over-regulation is definitely a major concern, and the possibility of banning certain procedures is part of the reason I’m OK with the lack of regulations we have right now. That doesn’t mean I wouldn’t love to see some reasonable safety guidelines set in place. I think there should be checks at least twice a year to make sure at the very least studios are running regular spore tests.

“The double edged sword is that it’s oftentimes one individual’s personal opinion that chooses what gets a regulation and what gets a ban.”

That’s very much true. When I first moved to Minneapolis I was discussing the ban on suspension with the inspector who handles piecing and tattoo shops. I asked her why suspensions were banned and she responded with something along the lines of: “Someone brought in a tape of it for us to watch. Have you seen that stuff?! My God.”

Seems as though they were pretty freaked out by it and so they went the route of banning. I don’t think any of the piercers involved in the process were interested in suspension, so I don’t think they fought it very hard, if it all.

I think it makes sense for cities/states to address them at the same time, so maybe in that sense they should be grouped together. However, I think it’s important that each discipline be addressed individually to make sure the regulations make sense, are effective and are enforceable.

They should absolutely, without exception, be treated as separate industries.

The problem is, if they’re treated as separate industries, most people don’t know much about scarification, implants, etc., so if they have to go make separate laws about that instead of grouping it all under a body art law they will most likely just make it illegal.

There are enough piercers, tattoo artists, and mod practitioners together to make up a legitimate presence at a hearing to pass laws about those issues. If they break it up separately there are a lot fewer people in each category and that makes it easier for them to pass laws to regulate us out of business completely.

Most laws for public safety in a piercing, tattoo, mod studio apply to any form of modification as well, so separating them is more of a headache for law-makers, too, which makes them less likely to want to do that. It’s much easier for a lawyer, politician, etc., to say, “Make that illegal” than to say, “Make it legal, but make sure that anyone doing it is complying with this 30 page list of rules and regulations I’m going to draw up.”

I don’t see any problem with grouping them together. Like Steve said, it makes it less likely that they will just make certain things illegal. For the most part, a lot of the regulations would be the same anyway: age requirements, spore testing, autoclave logs, single-use sharps, sharps disposal, etc….

OK, maybe I’m talking in an ideal world that they should be separate.

Honestly though, how much in common does tattooing have with any of the things that you all are discussing? Aside from the fact that they both are a modification to the body and that these days they share a building.

I’m sure to all of us the difference between piercing and tattooing is like night and day. But, to someone outside of the industry, they aren’t going to care. They’re just all things that make their granddaughters look like whores.

Tattooing has plenty in common. Like John pointed out, autoclave usage, spore tests, use of gloves, using sterilized single-use needles, disposal of sharps, use of disinfectants, etc. I’d say about 90 percent of the laws in most places could go for any type of modification, and only about 10 percent are specific to any one form of it.

Exactly. There are going to be some specific laws for each, but the most important regulations are going to be pretty universal.

I’ll step up to bat with this one.

I hate microdermals with a capital H. I think that while they do offer some possibilities that haven’t been seen before as far as placement and jewelry styles, they are problematic, hard to successfully heal for the long haul, and are just an all-around hassle.

I see a lot of them reject and leave pretty nasty scars, because most of the time the client isn’t looking at it on a regular basis (because of its weird placement) to see if anything is wrong with the piercing. I see a lot of them with massive piles of shmutz built up around them for the very same reasons.

People don’t tend to view them as “permanent” at all. It’s something to get done now, like an earlobe or nostril, and there is no forewarning about the issues that arise with them from most piercers.

When they started to get huge, I admit, we got on the bandwagon, but we have certainly backed off on our enthusiasm with them since watching issues arise. This past month, Vibe magazine had a blurb about microdermals in their fashion issue. It showed a piece on a girl’s side that we did, but what it didn’t show was me resetting that sucker back in there two weeks prior to the shoot because it had been shifting outwards.

I know that there are a lot of people gung-ho about them, and they can be fun, but I think they should be viewed much like surface work with a more permanent edge.

I was leaning towards a negative opinion of them a few months back, but then I started experimenting with longer stem lengths and now things are going a lot smoother. I’ve done about 250 of them over the last 18 months, I’d say the first 200 were 3/32″ rise, no matter the location. I was getting some tilting, and the occasional failure, but still maybe a 60-70 percent flat heal success rate. I think out of that initial 200 I personally removed maybe 15, and a few were cut out by other shops. Now with the 1/8″ and 5/32″ stems I haven’t had a single significant tilt or failure in about five months. The only ones I’ve taken out have been for work reasons, or people just not wanting them.

[Ed. note: Ryan adds, “I just checked my numbers on past microdermal orders and I'm under on my guess for how many I've done, but the success rates are still pretty accurate.”]

A big issue about them is removal. I’m the only shop in my area that takes them out without using a scalpel. I just use a needle and micro surgical hook to take them out without enlarging the stem hole at all. A lot of people are terrified of trying them because they think they have to get them cut out if they fail.

Overall I’m a big fan of them and I try to push people towards those over surface piercings for all nontraditional surface placements. With how easy they are for me to remove I don’t even refer to them as permanent. I just call them semi-permanent and offer future removal for free for any I’ve installed.

Does anyone else offer free removal as standard practice with a microdermal?

Microdermal rejection scars look fairly extensive from the photos on BME. Do you suggest to clients the immediate removal at the first signs of rejection or do you generally try to reseat the microdermal?

In what situations have you refused to do a microdermal?

I’ve tried re-seating once or twice but now I think it’s just pointless. And I usually tell people that if they can see the foot through the surface and there is any redness it’s time to remove it before you get an ugly scar. But if I take them out early I get barely any scar at all.

I only refuse if the skin is too delicate to support the jewelry—areas like the inner wrist or high anti-eyebrows. Or areas where you get a lot of friction, like low hip placements.

I have a pretty high success rate with microdermals as well. In a lot of cases I think they are a much better option than surface piercings. However, I think it is the responsibility of the piercer as a professional to go over the risks and make sure the client understands them. A lot of people make a big deal out of their “permanence,” but honestly, removal isn’t that hard. Like Ryan said, they don’t need to be cut out with a scalpel, and a lot of the time I can remove them without even using a needle. Scarring really isn’t anything major with these and it’s a lot less than you would get with a rejecting surface bar.

The only area I’ve seen consistent problems with these is along the collar bones, especially more towards the shoulder. I won’t even do them in that area anymore. Most of the ones I take out now aren’t because of rejection, it’s because the person didn’t want them anymore, or, in most cases, it’s because they were done with inferior quality jewelry. I always remove them free of charge since it’s something the client can’t do themselves, and I don’t want them trying to.

I’ve done these in a lot of different areas. A lot of my friends, including my girlfriend, have some that are over two years old now. These are in places like the lower back, sternum, anti-eyebrow area and above and below a navel.

I have re-seated some that were not that old, and they healed up fine. I think this really only works if the piercing is still fairly new. Scarring keeps coming up, but honestly I haven’t seen any real scarring from these at all.

I’ve had a 50/50 success rate with re-seating ones that are tilting; some work, some don’t. The areas I see the biggest problems are the back of the neck and cleavage, and the shoulder is a troublesome area as well, like John said.

We generally remove them for free, unless they were done elsewhere. I don’t cut them out either, just a little massage usually does the trick, although the feet with the big hole…those are a a lot tougher to remove, and sometimes need to be helped out with a needle. As for scarring, the worst I see tends to be on the rejecting nape placements. Lots of buildup with those, not pretty.

Are there any other placements you guys shy away from? We don’t do the thin-skinned areas Ryan mentioned, or hands or feet—too much trouble.

I do a lot of microdermals, and I also try to talk people into them instead of surface piercings when they come in for something like a sternum, anti-eyebrow, etc. I rarely take any out because of rejection—mostly I remove them because of issues at work/school, or the person just doesn’t want them anymore. I’d say from what I’ve seen we have about an 80 percent success rate with them.

I offer free removal if they were done at my shops, and sometimes even if they weren’t. There are a lot of shops around here that use the horrible ones made in Thailand/Korea/wherever it is that sell them for $1 or less. When educating people about them and why they aren’t working out for them, most of the time they understand what I’m saying and come back to get them done with the proper jewelry in them, so when it seems like a situation like that, I don’t charge for the removal.

When I remove them, I just massage the tissue until the heel can pop out, then pull them out. Sometimes I have to slide a needle underneath them to cut through the scar tissue that grows through the holes, but that’s only about 50 percent of the time. I’ve seen some scarring, but normally less than from surface piercings or other rejecting piercings.

If someone wants to keep the microdermal when it seems to be rejecting I’ll try re-seating them if there isn’t a lot of scar tissue built up already, or if there is, then I have them wait a few weeks till it goes down and can be re-done. The place I’ve noticed having the most problems with tilting out and needing to be re-seated more often than anywhere else is the lower-center forehead, the “third eye” position, or closer to the eyebrows there as well. I think this is due to all the movement in the area, so I warn people that come in for those before doing them.

There are several variations: solid base, one hole, two holes and three holes. Which design do you generally prefer?

I prefer the Anatometal pieces with one large hole. I’ve used the IS and Wildcat pieces as well; IS are my second choice. The bases on the Wildcat pieces are a little too thick for my liking, and the finish isn’t as nice as the Anatometal and IS pieces.
The Anatometal pieces tend to heal much better and more securely in place in my experience, however that does make them slightly harder to remove than the others.

I’ll chime in “thumbs down.”

I was really excited when I first saw them. I had a pair of them put in my forehead by Didier at Enigma a few years back and it didn’t take me long to start changing my mind. I’m also not a huge surface piercing fan to begin with so I guess I should have seen that coming.

The whole issue of removal was a great deal more complicated when people hadn’t removed them a whole lot. I don’t like doing them so generally I pass and book an appointment for the boss, but I’ve gotten very good at taking them out.

The biggest problems I see with healing is people’s inability to remember they have them: catching them, snagging them. I had one guy that had lost the top of an anchor he had in his nape while on vacation. The shop he went to put a 6 mm steel ball on the jewelry and he then spent a week in bed till he came to see me—the thing had grown out completely sideways.

But, curve balls aside, if someone is coming in to take an anchor out, removing the threaded end and attaching a threaded taper, gently enlarging the pocket under the tissue by stirring the jewelry a bit works pretty well for me. It feels a lot like losing a tooth; just kinda wiggle it until those threads let go. As Meg said, the large hole model is a little trickier.

That’s how I take them out too, Stephen, although remember that one disaster you had to remove when you were guesting here? That thing was so scary!

Yeah, that was one of the authentic “surface anchors” that has one half bent like a closed staple and an arm that holds the gem. It was the first time I had seen one and was a little puzzled. You can’t just wiggle those things out because of the shape; it’s similar to the old bar trick of folding a drinking straw in half and inserting it into the neck of a bottle to pick it up. For that one, I actually used the bevel of a needle to widen to hole enough to take out. That poor girl was completely freaked out.

That’s another thing about anchors: I think there’s just as many people who understate what can happen with anchors as those who get everyone all wound up about scalpel removal. I think it’s important to inform the client of possible risks without downplaying them or scaring the crap out of them, and also, to recognize the capabilities and limitations of anchors—meaning, they open options but they aren’t foolproof.

As for the base I prefer (back to Rachel’s question), I like the IS ones for ease of removal, but the Anatometal ones for staying power. Those suckers are tough to get out though. I’ve got a client that got a “Madison” placement dermal, and it rejected three times with the IS one. I popped in an Anatometal one, and it’s going strong at about eight months now.

I’m pretty thorough when I explain the hows, whys and removal aspects of them, but not everyone understands, even after a talking-to. People see pictures of all this crazy stuff done with them (like eyelids) and then get irritated when they find out that they can’t just take them out when they want to and put them back in like a standard piercing.

My big question for all of you is how long do you tell your clients they take to “heal”? I tell mine that they will settle in after a few weeks to a month, but can never really be called “healed,” as there is never gonna be a neat little dry pocket around that base.

Also, what is your aftercare suggestion for them? Do you have your clients bandage them initially?

I tell people the “initial healing period” is about a month, but that it can take a few extra weeks to toughen up. I also tell them to wait at least six weeks to come in for an end-piece change, or to wait three months if they want to do it themselves. I cover all mine with a Nexcare waterproof bandage and tell them to leave it on for anywhere from one to three days depending on the location.

Microdermals hit about the time that I started transitioning out of piercing so I’ve only done a handful. So, it’s really hard for me to formulate much of an opinion. [Ed. note: But that’s never stopped you before!]

As for my like or dislike of dermal anchors…personally, I like them. Less invasive than traditional larger transdermals and if well-placed they hold up infinitely better than surface piercings. If anyone has ever read one my rants you’ll know I’m not a big a fan of surface piercings…but I don’t want to get too far off-topic.

As for removal, I’ve helped with a couple, but that’s usually because Allen gets roped in when it requires brute force. I’m definitely not shy about getting out “stuck” jewelry. As for price, well, I’m sure everyone has their own opinion. Me, I think all removal and most general maintenance should be free, no matter who put in the jewelry. It’s been my experience that people normally tip really well for a free service. Plus, it’s good for business and ultimately good for the community. Each crappy piercing that walks down the street or appears in the media is a blow to the entire piercing industry…and you know how it is. There is a certain satisfaction about fixing someone else’s mistakes that really makes doing your job worthwhile.

Price is a good point. What are you guys charging to do microdermals? Do you include the foot in the price?

Our cost is $75 for the service, which includes the base, then the additional cost is what frontal you want on it—disks or gems or whatnot. And we take them out for free.

I charge $80 for one and $60 for each after (in the same session on the same person) with a disc on them. If they want gems, etc., the price goes up depending on the end.

I charge $70 for one, $130 for a pair, $60 each for three or more. Price includes standard disc ends; gemstone or alternate ends are an additional $10-$15 each. Free removal if I installed it, $20 if it was put in somewhere else.

I charged $80 when I was first doing them, but now with IS lowering their prices I can’t see charging that much. I only charge $65 for a surface piercing with an Anatometal flat surface bar and those cost twice as much as microdermal jewelry.

I charge $75 for one with a flat disc, more if they want a gem. Each additional one done after that I take a little off the price. Free removal whether I installed it or not.

I believe were running $50 for a basic disc, $75 for gems.

Since we’re talking microdermals, I’ve had two different people come in over the last two days that both had microdermals done on their sternums at a different shop in Syracuse. One girl’s fell out within a day, and the other girl’s was sticking way out and was about to fall out. I’m not sure what method was used to put these in, but there was a huge pocket made. In the one that was still in, there was a gaping hole around the post of it. The rise used on both of them was far too long for these girls as well.

I think most people in this forum are probably getting somewhere in the 85-90 percent success rate with microdermals, but I think it’s really important to remember that we aren’t the majority of piercers out there. There are going to be a lot more piercers only getting 50 percent success rate or maybe 75 percent at best. This could be from any number of things: using poor quality jewelry, poor installation technique, poor aftercare, poor placement, or just not really understanding what a microdermal is.

My point is, with piercing, but especially microdermals it is important for the client to do their own research first. It is also important for the practitioner to make sure they fully understand microdermals, and how they work.