Anatomy of the Body for Piercers Elayne Angel€¦ · Anatomy of the Body for Piercers Elayne Angel APP 2016 13 Risk of serious, widespread infection due to the depth of tissue involved

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 9

§  Nipples are devoid of •  Hair follicles •  Sweat glands •  Adipocytes (fat cells)

§  Areolae contain numerous sebaceous and sweat glands and hair follicles

§  Raised structures on the areolae are Montgomery glands or tubercles, or areolar glands

§  Normal variation §  Provide lubrication during

breastfeeding §  Best to avoid piercing them

§  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

§  Post-surgical anatomy §  Pierce only if pliable, wait

1+ years post surgery

§  Inverted nipple §  Pierce only if it

can be everted

§  Piercing too wide §  Curved bar poor choice

§  Pierce at the base of the nipple in the natural creases

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 10

§  Male nipples are

somewhat analogous to

female nipples

•  Smaller size (usually)

•  Lack the glandular tissue

and adipocytes that female breasts contain

§  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

can safely go in as little as

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 umbilicus is the remnant from the umbilical cord

§  The navel is a scar

§  The “umbilical tip” is the center of the navel

§  The “periumbilical skin”

is the tissue that

surrounds it

§  This is what we

traditionally pierce

§  Firm attachment point to

the underlying

subcutaneous tissue

§  In contrast to the

otherwise loosely

attached skin over the

abdominal wall

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 11

§  Note communication of navel with liver tissue

§  Hollow areas are the bowel--near the navel

§  A perforation of the GI tract: peritonitis (infection)

Round Ligament

Liver

Navel

§  In full abdominoplasty (tummy tuck) the navel

is cut free and sutured

in a new location

§  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 pierceable-in perineum between fascia)

§  Body §  Glans

§  3 cylindrical bodies of

erectile tissue: •  2 bodies of corpus

cavernosum •  1 cylinder of corpus

spongiosum (contains urethra)

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 12

Penile blood supply:

§  Dorsal artery (terminal branch of external iliac artery)

•  Supplies fascia, skin of penis, corpus spongiosum

§  Deep arteries/cavernous arteries

•  Supply corpus cavernosa via penetrating helicine arteries

§  Use a bright light to illuminate tissues

§  Avoid deep structures

§  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 dorsal vein, nerve, or artery

§  Use a strong light to locate the vessels

§  Risk of puncturing cavernosal arteries §  Vessel damage can cause excessive bleeding

§  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)

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 13

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

§  Female external genitalia is

comprised of the following

potentially pierceable spots:

•  Mons pubis

•  Labia majora

•  Labia minora

•  Clitoral glans (clitoris)

•  Prepuce (clitoral hood)

§  Clitoris: erectile organ composed of two crura, two corpus cavernosa

§  Glans covered by prepuce (hood)

§  Clitoral body (“shaft”) connected to the glans

§  The clitoral glans is

homologous to the penile

glans

§  Sexual arousal is the only

function of the clitoris

§  It contains 8000 sensory

nerve endings, (not 4000, like

the penis does)

§  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

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 14

§  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 bone necrosis (death)

Sternum piercing

Pressure on the bone here à could be problematic

Scarring from rejected

surface piercing

There is generally less scarring from surface anchors (vs. surface piercings)

Scarring from anchor Long-term success here is

highly unlikely:

§  The area gets too much

movement and trauma

§  Ornaments are not

perpendicular to the surface

§  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

§  Alongside of those are the nerves

§  Synovial tendon lining (dark)

§  Infection can easily spread far

AnatomyoftheBodyforPiercers ElayneAngel

APP2016 15

Vascularity of the hand

§  Greater infection risk than

many other areas

§  Likelihood of trauma

§  Be aware of the

complexity of 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