tube placed at the end of the needle. In some countries, the piercing needle favoured in the United States is regarded as a medical device and is illegal for body piercers. The procedure is similar to the piercing needle method, but the initial jewellery is inserted into the back of the cannula and the cannula and the jewellery are then pulled through the piercing. More bleeding may follow, as the piercing is larger than the jewellery. The dermal punch A dermal punch is used to remove a circular area of tissue, into which jewellery is placed, and may be useful for larger cartilage piercings. They are popular for use in ears, though not legal for use by nonmedical personnel in some parts of the United States. The piercing gun The vast majority of women in the west have their ears pierced with a piercing gun. The safety of piercing guns, which were originally developed for tagging livestock, has been disputed. The Department of Health of Western Australia does not recommend their use for piercing body parts other than the lobes of ears, and the Association of Professional Piercers recommends that piercing guns not be used for any piercing, requiring members to agree not to use piercing guns in their practice. Cork Cork may be placed on the opposite side of the body part being pierced to receive the needle. Forceps Forceps, or clamps, may be used to hold and stabilize the tissue to be pierced. Most piercings that are stabilized with forceps use the triangular-headed "Pennington" forcep, while tongues are usually stabilized with an oval-headed forcep. Most forceps have large enough openings in their jaws to permit the needle and jewellery to pass directly through, though some slotted forceps are designed with a removable segment instead for removal after the piercing. Forceps are not used in the freehand method, in which the piercer supports the tissue by hand. Needle receiving tubes A hollow tube made of metal, shatter-resistant glass or plastic, needle receiving tubes, like forceps, are used to support the tissue at the piercing site and are common in septum and some cartilage piercings. Not only are these tubes intended to support the tissue, but they also receive the needle once it has passed through the tissue, offering protection from the sharp point. Needle receiving tubes are not used in the freehand piercing method. Anaesthesia Anaesthesia is supplied by