The pose of the microdermal piercing usually takes longer than the pose of any other piercing. It is usually done with "dermal punch", a sort of needle larger or smaller to dig the skin, like coring. We actually dig the skin from above, then forward, then back, to prepare the hole that will host the base of the microdermal piercing. The technique seems to be barbaric, but the pain is largely bearable and much less intense than what one can imagine, it is even surprising ! The jewel is then inserted into the hole using a special pliers to hold it by the end.