On February 1st, 2008, Gabriele of Maxart Bodypiercing in Rome, Italy did a scalpelled nape procedure, and a year later it had healed nicely (as you can see in the left image below). A little redness and scarring around the edges (zoom in for a closer look), but almost none of the rejection or migration as is common with surface piercings done without surface-specific jewelry. By using a scalpel rather than a needle to create a large, non-destructive hole, big enough to form a “flap” that could sit comfortably over the jewelry without the jewelry putting pressure on the tissue above it, Gabriele avoided using something like a surface bar specifically designed to mitigate the pressures that lead to tissue dying off. Surface bars are great of course, but many people prefer the look of a ring to a pair of beads, especially in this age of microdermals. As you can see in the right two pictures, taken at five years after the piercing was done, it’s remained very solid long-term — and as the late Erl proved, piercings like this (his nape was almost identical) can last for decades.