 The standard method in the United States involves making an opening using a beveled @-@ tip hollow medical needle , which is available in different lengths , gauges and even shapes . While straight needles are useful for many body parts , curved needles are manufactured for areas where straight needles are not ideal . The needle selected is typically the same gauge ( or sometimes larger as with cartilage piercings ) as the initial jewellery to be worn , with higher gauges indicating thinner needles . The needle is inserted into the body part being pierced , frequently by hand but sometimes with the aid of a needle holder or pusher . While the needle is still in the body , the initial jewellery to be worn in the piercing is pushed through the opening , following the back of the needle . Jewellery is often inserted into the hollow end of a needle , so that as the needle pulls through the jewellery is left behind . 
