Anatomy of the Body for Piercers

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1 Nipples are devoid of Raised structures on the areolae are Montgomery glands or tubercles, or areolar glands Normal variation Provide lubrication during breastfeeding Best to avoid piercing them Hair follicles Sweat glands Adipocytes (fat cells) Areolae contain numerous sebaceous and sweat glands and hair follicles Fissured with multiple lactiferous (milk) ducts opening onto them A properly placed, average sized piercing will not seal off all the ducts Should not prevent breastfeeding, though some colostrum or milk may come from the piercing The subcutaneous nipple tissue is mostly circularly arranged smooth muscle Compresses the lactiferous ducts during lactation Erects the nipples in response to stimulation Piercing too wide Curved bar poor choice Post-surgical anatomy Pierce only if pliable, wait 1+ years post surgery Inverted nipple Pierce only if it can be everted Pierce at the base of the nipple in the natural creases 9

2 Male nipples are somewhat analogous to female nipples Smaller size (usually) Lack the glandular tissue On flat nipples, piercing should encompass a minimum 3/8 (10mm) between entry and exit when relaxed If nipple is defined with substantial height at tip, piercing and adipocytes that female can safely go in as little as breasts contain 5/16 (8mm) width of tissue Superficial fascia has 2 layers: Camper's fascia, the fatty outer layer, (more superficial) Scarpa s fascia: deep fibrous/membranous layer Note extent of subcutaneous fat and muscle fascia The umbilical tip is the center of the navel The periumbilical skin is the tissue that surrounds it This is what we traditionally pierce The umbilicus is the remnant from the umbilical cord The navel is a scar Firm attachment point to the underlying subcutaneous tissue In contrast to the otherwise loosely attached skin over the abdominal wall 10

3 Round Ligament Navel Liver In full abdominoplasty (tummy tuck) the navel is cut free and sutured in a new location Note communication of navel with liver tissue Hollow areas are the bowel--near the navel A perforation of the GI tract: peritonitis (infection) It is dense, tight scar tissue not a good place for a piercing Laparoscopic scars of the lower umbilicus aren t always an issue for traditional navel placements Ports are also commonly inserted near the exit side of a standard navel piercing Check to confirm Umbilical hernias can develop due to: Developmental deficiencies Congenital umbilical hernia Weakness in the linea alba in the midline of the umbilicus Post operatively Disruption of bowel wall must be avoided Complications include: Peritonitis secondary to bowel perforation Possible sepsis due to spillage of enteric (intestinal) bacteria into abdomen If not emergently treated with surgical repair and aggressive antibiotics: septic shock, cardiovascular collapse, death Root (not pierceablein perineum between fascia) Body Glans 3 cylindrical bodies of erectile tissue: 2 bodies of corpus cavernosum 1 cylinder of corpus spongiosum (contains urethra) 11

4 Penile blood supply: Dorsal artery (terminal branch of external iliac artery) Supplies fascia, skin of penis, corpus spongiosum Deep arteries/cavernous arteries Use a bright light to illuminate tissues Avoid deep structures Supply corpus cavernosa via penetrating helicine arteries Pinch up and pierce the loose, pliable tissue Piercings through the spongy tissue of the glans Location of cavernosa in glans is variable Palpate/illuminate glans near corona to identify cavernosa Risk of puncturing cavernosal arteries Vessel damage can cause excessive bleeding Risk of puncturing dorsal vein, nerve, or artery Use a strong light to locate the vessels Spermatic cord and tissues overlying the testis come from the abdominal muscles (external and internal oblique and transversus abdominis) Spermatic cord contains arteries, veins, nerves, and the vas deferens (tube for passage of sperm from the testis) 12

5 Female external genitalia is comprised of the following potentially pierceable spots: Mons pubis Labia majora Labia minora Risk of serious, widespread infection due to the depth of tissue involved and the closed spaces that communicate throughout the scrotum, spermatic cord, and abdominal wall Clitoral glans (clitoris) Prepuce (clitoral hood) The clitoral glans is homologous to the penile glans Sexual arousal is the only function of the clitoris Clitoris: erectile organ composed of two crura, two corpus cavernosa Glans covered by prepuce (hood) nerve endings, (not 4000, like Clitoral body ( shaft ) connected to the glans the penis does) It contains 8000 sensory Look carefully under bright light for vessels to avoid Common along the sides at the base of the hood Can be prohibitive to proper placement of HCH and/or triangle Risk of scarring Risk of infection Pressure issues Fascia layers Muscle Compartments 13

6 Direct, continuous pressure can cause diminished blood supply to the surrounding tissues/structures Could lead to tissue or bone density loss Worst-case scenario, tissue or Sternum piercing bone necrosis (death) Pressure on the bone here à could be problematic Scarring from anchor Scarring from rejected surface piercing Long-term success here is highly unlikely: The area gets too much movement and trauma Ornaments are not perpendicular to the surface There is generally less scarring from surface anchors (vs. surface piercings) Anchors tilted and migrating Surface anchor neck project Truly long-term success, in general, is unlikely (when compared to traditional body piercings) They may last for weeks, months, or sometimes years Educate your clients that surface anchors may be temporary adornments! Obviously a goner Larger white structures are tendons Synovial tendon lining (dark) Alongside of those are the nerves Infection can easily spread far 14

7 Greater infection risk than many other areas Likelihood of trauma Be aware of the complexity of hand Vascularity of the hand anatomy before piercing Rich blood supply via terminal branches of several arteries Return blood flow via corresponding veins, and internal and external venous plexus Possible complications: Uncontrolled bleeding Incontinence (gas and/ or feces) INFECTION Infection of anal mucosa Extension into ischioanal fossa Ischioanal abscess Pelvirectal abscess Rectal fistula No adipose tissue (padding) in eyelid Repeated trauma, abrasion, possible laceration Pain Scarring of cornea with eventual loss of function 15