When Frank Sinatra sang his hit song I’ve Got You Under My Skin, we’re sure he wasn’t crooning about subdermal implants, because they weren’t around in his time. Today, there is a whole new meaning to Frank’s phrase about love, in the growingly popular practice of implanting “body jewelry” beneath the skin’s surface, which results in a raised design.

The idea for subdermal implants is attributed to body modification pioneer Steve Haworth. It began when a customer came into Haworth’s body piercing shop in Phoenix, AZ and asked for a bracelet tattoo. Haworth suggested that he could implant a row of beads beneath the woman’s wrists to create the desired effect, enhanced. The rest is history, as many well-known body modification artists adopted and expanded upon the practice. Haworth has since designed what he termed “dermal elevators,” which are specialized medical instruments to assist in the subdermal implant process.

Typical implants are made of Teflon or implant-grade silicone, which can be designed to create any desired shape. The implants are completely buried beneath the skin. However, any material that is biocompatible will work, such as implant-grade stainless steel or titanium; even high-karat gold has been used. (Transdermal implants are a variation of subdermal implants; this process involves placing objects partially under the skin as the remainder of the implant is exposed above the skin.)

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The procedure for subdermal implants is quite simple. An incision following the grain of the skin is made down to the subcutis. A dermal elevator is used to separate the subcutis from the fascia to create a pocket into which the implant is placed, and then the wound is stitched. The results can produce dramatic sculptural change to any part of the body, but it can take up to 3 months to reach the desired effect.

Implants can also be stretched. You begin with a small implant. After the healing process is complete, the small implant can be removed and replaced with a slightly larger implant; this process can continue with bigger objects being implanted until the final size is achieved.

During the healing process, subdermal implants can and do shift, which alters the desired effect. However, careful placement of the implant in relation to the body’s anatomy can minimize migration. In addition, the insertion pocket affects the implant’s ability to move, so care must be taken when creating the depth of the pocket. Depending on the area of the body, the body modification clinician can select a dermal elevator with the most advantageous design and level of sharpness required. Pressure bandages applied over the stitches for the first few days after the procedure can also help to minimize movement as the skin fuses around the implanted object. In addition, the patient is advised not to sleep on that part of the body during the healing process, as the additional pressure and weight may push the buried object well out of place.

Popular shapes for subdermal implants include stars, hearts, balls, horseshoes, starfish, religious crosses, circles, skulls, musical notes, and animal faces, but even ice cream cones and cupcake shapes have made their way below the surface of the skin in some body modification aficionados.


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