In 1994, tattoo artist Steve Haworth made history by performing what is largely considered the first modern subdermal implant procedure for body modification purposes.
On that day, a customer from abroad asked him to come up with something new — a bracelet, but unlike anything that had been seen before. Haworth, ever the trendsetter, proposed an unusual procedure whereby he’d insert a series of beads under her skin to create the three-dimensional effect of a bracelet.
Since then, cosmetic subdermal implants have grown in popularity, leading to new and more creative expressions as well as more refined practices. However, the trend is rife with controversy and the dangers of subdermal implants are not to be ignored.
Above: Wrist beads, the first subdermal implant procedure performed in 1994 (top), and more recent work by Steve Haworth.
Understanding Subdermal Implants
Subdermal implants are not your typical body modification trend. Unlike the more traditional tattoos and piercings, these implants involve actual surgery.
During the procedure, the artist makes an incision into the subcutaneous layer of the skin, cutting all the way into the fat layers beneath the skin. He or she then uses a long thin device called a dermal elevator or dermal separator. This tiny spatula like tool separates the subcutaneous fat from the fascia, creating a cavity, or insertion pocket, into which an implant can be introduced.
After the subdermal implant is inserted, the incision is stitched up. The artist may also use surgical tape or pressure bandage to keep the implant firmly in place over the span of a week or two. The skin then heals around the shape of the implant, creating the effect of a design or feature that is actually part of one’s body.
Transdermal implants are inserted in much the same way as subdermal implants. However, part of the implant is still above the skin. The part underneath typically has holes in it for the skin to heal into, making the implant permanent. Suture tape is often used to keep the incision “closed” around the exposed portion of the implant.
Safe in Theory
Now that you understand the nuts and bolts of the procedure, you’re probably wondering if it’s really all that safe to be putting things under your skin.
The truth is that subdermal implants are not that uncommon in the medical community. Breast implants are, in effect, subdermal implants. They involve a silicon structure inserted under the skin to add shape and size to an area. Many surgeons create similar cavities in the skin for technology like pacemakers. Subdermal contraceptive implants are becoming increasingly more popular, and new technology, like this implant intended to treat HIV, is pushing the limits of what subdermal implants are capable of.
In short, the act of placing synthetic materials under the skin for medical or cosmetic purposes is not itself unusual or particularly harmful. But that doesn’t mean that subdermal implants for body modification do not pose significant health risks.
The Problem of Qualification
When used for unconventional forms of body modification, subdermal implants are lumped in with tattoos and piercings. For this reason, many people don’t think it’s odd that they are getting plastic surgery done in a tattoo shop instead of a clinic.
During the procedure detailed above, deep incisions are made with a scalpel. Does it hurt? “Yes, it hurts, both during the procedure and after during the healing period,” says Haworth on his website. Remember that you don’t get anesthetic because your “surgeon” isn’t a licensed medical professional, and therefore doesn’t have access to the proper anesthetic nor the legal authority to administer it.
If the pain doesn’t turn you off, try picturing the procedure being performed in a studio that hasn’t been properly sterilized. While most body modification practitioners go to great lengths to ensure that their work is performed in a sterile environment, many tattoo artists and piercers — talented and creative though they may be — do not have the training and resources required to adhere to the necessary medical protocols.
What’s more, the quality of the material being placed under your skin may not be up to par. While the sale of medical grade silicone breast implants and other such materials is highly regulated, “extreme” body modification implants aren’t subject to the same stringent research and testing.
Risks and Complications
Make no mistake, the risks associated with body modification are extensive and having the procedure performed in a non-sterile environment by an untrained individual only exacerbates that. Some of the following complications are fairly common and others extremely rare, but they should all be taken seriously.
- Infection – This could happen in any number of ways. The infection could come from the poorly sterilized room. Bacteria could hide inside of a pre-carved silicone piece. Infection could also come long after the procedure with poor aftercare.
- Nerve damage – Really, this could mean nerve, muscle, or lymph damage. An implant may put pressure on any of these physical features, interfering with function and causing bruising or fluid retention. This is also typically painful.
- Implant rejection – This refers to the body naturally pushing the implant from the body in the same way that it might push a splinter out of your thumb. This is more likely when implants have been placed poorly, are too large, or have outward facing points. This complication is sometimes accompanied by severe scarring.
- Negative reaction to materials – This happens in two ways. The material may not be biocompatible. That’s why certain materials are preferred, usually silicone. However, if the quality is low enough, otherwise acceptable materials could present problems. People can also have allergic reactions to their implants. This can happen even if you’re not typically allergic to that material. These allergies range from mild to severe.
- Tissue resorption – Has your dentist ever told you to stop brushing so hard, because your guns were slowly receding? This eroding of tissue over time due to friction can happen with subdermal implants as well. The foreign object rubs against your tissue over a long period of time, wearing it away. This can happen over a period of decades, or it can happen in as little as a few months. You may not know it’s happening either until your muscles have already been significantly damaged and, in some cases, your bone exposed to the implant. According to the Body Modification Encyclopedia, this is perhaps the most common and least well-known complication.
When subdermal implants go wrong, they tend to go very wrong. Individuals who have suffered from implant rejection, tissue resorption, or infection have sometimes faced further surgery, including skin grafts, and disfigurement.
The Controversy Continues
Given all of this, why can’t you just get your your new horn implants at a doctor’s office? As Seattle based plastic surgeon Dr. Phil Haeck told Wired Magazine back in 2006, subdermal implants for extreme body modification are a “deviation in surgery” and have “no place for someone who has taken the Hippocratic oath.” He also noted that any infection resulting from a lack of sterilization would be a “disaster.”
Other surgeons may not share Dr. Haeck’s negative view of the practice, but their hands are tied nonetheless. The Code of Ethics for the American Society of Plastic Surgeons states that surgeons may be subject to disciplinary action if they perform a procedure that’s considered “unjustified” or “not calculated to improve the benefit of the patient.”
Of course, this raises the question of what is justified. Are breast implants justified? Is it enough that the patient wants them and would feel better with them? If so, why doesn’t that same leniency extend to more extreme body modification?
Wired attempts to bridge the gap by choosing to interpret the above statement as an indictment of any surgeon who modifies the body away from societal norms. But in the absence of qualified, licensed medical practitioners, how can someone seeking a modification stay safe? As Wired suggests, “seeking out experienced people with proper tools is key, just as you would when you look for a piercer or a doctor.”
Cover photo: LED light subdermal implants, credits Vice Motherboard.