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Septum Piercing Beaten To Death

The Septum Piercings are one of the most widely worn and oldest non-ear piercings known to man. It also allows one to hide in easily when needed which is not common with facial piercings. Over the years I have done this piercing on a number of professionals that were not allowed to wear visible piercings at work. Wearing either a Septum Retainer or Circular Barbell allows the wear to flip the jewelry up and into the nostrils.

If you polled most piercers about what are their least favorite piercing to do, Septum piercings would be high or on top of the list. The main reason is that no one's nose is completely straight. When marking the placement of the piercing it's a struggle between the piercee's anatomy and what is going to look "straight" or fit into the person's facial structure. Swelling during the first few weeks can make the piercing appear to be crooked too. Siince the most common jewelry used is an expanded Circular Barbell, sometimes the jewelry itself will end up a little crooked. In some cases the pressure of the Septum cartilage can cause the jewelry to shift or move during healing. So, though the piercing was done correctly, a few months later is will no longer be straight. I will try expand on this later and your piercer should cover these issues with you during the consultation.

History and Background:

The Septum Piercing is the second most common piercing, right behind ear piercings in primitive cultures. It is even more common than nostril piercings. It is believed that the popularity was the eash in which the piercing can be stretched and allow the wearing of large jewelry fashioned often out of animal parts like tusks, feathers and bones. The piercing was worn to make one more attractive and the larger the jewelry the more intimidating by giving the impression that the person had tusks.


The wearing of Tusks in the piercing was predominant warrior cultures on the Pacific Islands including the Solomon Islands, Jaya, Irian and New Guinea. The Asmat tribe of Iran Jaya wore a large Pig Leg Bones or the bones of enemies slain in battle with diameters as large as an inch called Otsj.   

Aboriginals in Australia pierced the Septum in an effort to flatten the nose. They would pass a long stick or bone through the piercing causing the nose to expand downward and appear more flat. In Nepal and Tibet a pendent called a Bulak is worn from their septum. The jewelry can be so large that the wearer must lift the jewelry to eat or drink.

In south and Central America, the Aztec, Maya and Inca Cultures wore a range of jewelry in their septums including those made of Jade and Gold. The tradition is still carried on by the members of Cuna Culture in Panama that continue to this day to wear thick gold rings.  Many North American Native Tribes also wore Septum piercings. Most notable is the Nez Perc tribe who were named after the French words for Nose Pierced.

In most cultures the piercing signified the person’s entrance into adulthood. The piercing was than stretched over time to signify the maturity and status in the tribe. For example, the more fearless and accomplished the warrior the large the jewelry.

In modern Western Culture the piercing seemed to have came into popularity in the Punk and Rock Subculture in the late 70s and early 80s. Coming more and more common with the popularity of Modern Piercing. Though often only worn by the more extreme members of the piercing culture in the past, since 2010 the piercing has become more popular and more mainstream excepted.

Anatomy, Marking and Placement:

There is a large triangular piece of cartilage that makes up a majority of the septum and then a thinner lose piece of cartilage at the bottom of the nostrils entrances. The “Sweet Spot” and most common location of the piercing is the area between the two. If you take your thumb and fore finger and pinch or pull downward, you will notice the two plates separate and there is a thinner area between them.

Sometimes the sweet spot is so small that it will not allow enough room for the jewelry. This isn’t usually a huge issue but as I mentioned before the pressure of the septum cartilage on the jewelry can cause the piercing to shift or migrate and make the piercing appear to be crooked. This can sometimes be corrected by applying pressure to the piercing during the healing by pulling on the side that seems higher or twisted back.

The traditional placement is as far forward as possible so that the jewelry will hang free of the upper lip. The piercing can be placed further back or even above the “sweet spot” if you wish. Though piercings through the thicker cartilage will take longer and be more of a challenge to heal. Of course piercing above the sweet spot will also be more painful.

When marking I have the piercee lay reclined with their head tilted back over the edge. This way I can see easily into the nose. I will usually first mark a straight line at the bottom of the septum to dictate how forward or back the piercing will be placed. Also I will use this as a guide for the angle of the piercing. Next I will locate the sweet spot. Over the years I have found that first pinching on the tissue and then releasing the tissue works best. When marking you want to have the tissue as natural as possible. When marking I will apply slight pressure to insure that I have the sweet spot, yes you can tell the difference.


Though it is not common I have done a grouping of three Septum piercings. If this is something that you are considering and have the room in your anatomy to get more than one, you should mention this at the time of the first piercing. It may affect the placement of the first piercing. I would not suggest doing more than one at a time. I found that since the area is tight that after the first one it seemed that the placement had shifted from the swelling.


As you know from the history, the septum can be stretched and it may affect the shape of the nose itself. Like any piercing it take time to allow the piercing to grow tissue and toughen. Slow and steady is the best course. Usually considering twice the healing period between each stretch.

Jewelry Size and Type:

The size of the jewelry should always be based on the anatomy of the client. Both the shape size and thickness of the area should be considered when choosing jewelry. Also their plans for the future.

There are issues that should be considered before choosing jewelry size and type:

  1. The thickness of the jewelry will either increase or decrease damage to the piercing in the future. Also a thicker gauge may increase the period of time the piercing can be left empty. It is a balancing act between a thickness that will not tear easily but you want the jewelry light enough to not add extra stress to the piercing during healing. Generally I like to pierce Septums at 14g or 12g. With larger gauges, you are making a larger piercing which means that there is more blood vessels that are going to be cut or nick. Which means that the larger the gauge the more bleeding and the longer the bleeding will continue. Since there is more impact and trauma to the area with larger gauges, it means more inflammation and longer recovery time.

  2. The width needs to be wide enough to not only pass comfortably through the piercing without causing pressure on the piercing but to allow for inflammation and cleaning. The standard is to have an 1/8 to 1/4 of an inch of extra space between the width of the piercing and the width of the jewelry.. With rings not only does the width need to allow for swelling but should hang freely for the Septum. If the ring is too small and tight to the bottom of the septum this will add additional stress to the piercing that could lead to migration, prolonged healing, tearing and other issues.

  3. When picking the gauge of the jewelry there also needs to be a discussion about whether or not the piercing is going to be stretched in the future. Not only would piercing at a larger gauge speed up them getting to their goal but piercing at a small gauge and allowing the piercing to heal completely, can lead to a stronger piercing. A Stronger piercing will stretch much more easily without issues.

Jewelry Styles:

  • Captive Bead or Beaded Ring - A circular ring with a fixed bead or ball or a bead or ball that is held captive by the tension of the ring. For piercing and healing, depending on anatomy,  The ring’s width also needs to be wide enough to hang freely below the septum. The most common size is 7/16 to 1/2 for healing. This is to insure there is space for swelling but also to make sure the piercing area is as flat as possible.

  • Circular Barbells - A circular shaped horseshoe with two threaded ends. Generally I feel they are the best option because they can be flipped up easily during healing but are more secure than Septum retainers. I start with a 3/8 width and then expand the jewelry to fit the client’s anatomy. This has the advantage of decreasing the length of the jewelry and allowing it to fit comfortable inside the nostrils. There is two disadvantages though, the expanded jewelry can sometimes expand in a way that will make the piercing appear crooked. The other is that the ends can come unscrewed and will need to be checked on a regular bases.

  • Septum Retainers - A U shaped piece of jewelry without a closure. Can easily be flipped up and sized to allow for swelling with all the advantages of a circular barbell. However since there is no closer, they can fall out and be less secure when worn down.

  • Clickers and other styles - It seems recently there are a number of new styles of jewelry that have came into the market targeted toward females. Most of these are not of the highest quality and often made of substandard materials. Be careful especially about the metal the jewelry is made of.

  • Silver - Never use any jewelry made of Silver. This will lead to silver poisoning.

For more detailed information on what Jewelry to buy go to my blog Post Healing Jewelry Guide


I always do the piercing Free Hand with a Needle Receiving Tube. I was trained to use forceps but I have found that they tend to increase the likelihood of the piercing being crooked because they alter the shape of the anatomy. A number of piercers use specialized forceps with a tube on each side. I have always felt that they would have the same issues as standard forceps.

The Procedure:

  • Consultation and paper work.

  • Evaluating the piercee's anatomy to insure that the piercing can be done safely and to size the jewelry.

  • Setup

  • Disinfecting the piercing area with a surgical scrub

  • Recline the piercee with their head tilted over the edge.

  • Marking the piercing

  • Place the needle receiving tube on the exit point of the piercing.

  • Lining up the needle and distract the piercee.

  • Injecting the piercing needle through the piercing area and into the needle receiving tube

  • Insert and closing the jewelry

  • If done with a Circular Barbell or Septum Retainer, I will check to make sure the jewelry can be flipped up. If not I will adjust the jewelry till it can be done easily.

  • Stopping any bleeding and cleaning up the piercing area.

Hassles and Aftercare:

Though they heal rather quickly healing in two to three months, during the first couple of weeks they are prone to discoloration, redness, tenderness to the touch, bleeding, redness and swelling.

Basic aftercare will involve hot soaks or hot compresses with warm water and sea salt twice a day and cleaning the piercing in the shower twice daily. Also you will need to take steps to reduce the likelihood of cross contamination. For more details go to Basic Aftercare Instructions.

If the piercing seems to have shifted or seems crooked, gentle pressure in the direction that would correct this or make it seem more straight should be done during the healing period a few times a day. There shouldn’t be pain and make sure to wash your hands before you start.


I’ve heard mixed results from clients over the years from it being the most painful piercing they have ever experienced to stating they didn’t feel the piercing beyond pressure and a pinch.  You may experience throbbing and aching for about 20 to 30 minutes after the piercing is done. Then there will be tenderness to the touch for about 2 weeks.


Risks & Concerns:

The area is blood rich and not prone to infection or other problems. However, the piercings need to be babied during the healing period. Sleeping on the piercing or piercings should be avoided and any other stress on the area.


If your employment doesn’t allow visible piercings and you want one, it’s easy to hide a Septum piercing during the work week and then flip it down and show it off to the world on the weekend. Everyone’s anatomy is different and never completely straight. So, you should understand that the piercing may appear slightly crooked when you look at it up close. While at arms length it will appear perfectly straight. This might have more to do with the shape of your face than the skill of the one that did the piercing.