Transdermal implants create the appearance of external objects implanted straight into the body. In reality, the implanted object is an anchor with a threaded post. The post protrudes through a hole in the skin, and "jewelry" screws onto it.
In Aylward's "metal mohawk," now removed, the jewelry was thin metal spikes up to 1.5 inches (3.8 centimeters) long [source: Webb]. Body-mod artist Samppa VonCyborg has a mohawk of stout horns [source: Larratt]. Dennis Avner, aka "the Cat Man," now deceased, screwed whiskers onto implants in his eyebrows [source: Stokes]. Some people choose more traditional jewelry, like stars or studs that sit flush to the skin. An NYU professor who got transdermals in 2010 for an "art project" screwed a camera onto three implants on the back of his head [source: Orden].
Body-mod pioneer Steve Haworth designed both the procedure and the first anchor, drawing on a background in medical-tool engineering [source: Stokes]. Those in use 20 years later look a lot like the original.
Anchors are typically forged of implant-grade titanium [source: Russ Foxx]. Often custom-made, their exact designs can vary but generally consist of a flat base, either a circle or a rounded rectangle, that has a perpendicular, threaded post at the center [source: Beyond Body Modification]. The base has multiple openings in it, allowing scar tissue to grow through and firmly embed it in surrounding tissue, placing transdermals in the "permanent mod" category [sources: BMEzine Encyclopedia, Beyond Body Modification]. Size depends on the intended jewelry, with bases ranging from 6-16 millimeters (0.2-0.6 inches) in length or diameter and posts ranging from 1.5-5 millimeters (0.06-0.2 inches) tall and 2-8 millimeters (0.08-0.3 inches) in diameter [source: Rock The Body].
A lot of the controversy surrounding the modification relates to the procedure required to implant the anchor, which can only be described as surgery.
Of course, performing surgery without a medical license is legally hazy at best, so if you're the one doing the surgery, you'll likely describe it as "art" [source: Stokes].