A body-mod wiki user tells of a man with a transdermal mohawk who developed an infection at an implant site. It briefly hurt but then seemed fine, and while he went about his life the infection quietly left the surface and traveled inward, eating a hole in his skull that finally left him in so much pain he went to the hospital, where he traded out his implants for a metal plate in his head [source: BMEzine Encyclopedia].
True? Who knows. The important thing is, it's entirely possible.
Transdermal implants have an estimated "success rate" of 20 percent, which might be high [source: Philips]. Even in the extreme-mod community, they're considered high-risk – more so than subdermal implants, which often heal quite nicely [source: Beyond Body Modification]. The big problem with transdermals is that the implant site is open to the environment [source: Beyond Body Modification]. Infection is pretty likely [source: CBSNews].
Infection is one of the biggest risks associated with transdermals, especially the inward-traveling kind that can eat a hole in a skull. Others include deep transdermal placement, in which the artist places the anchor too deep, potentially damaging muscle and bone and leaving the area particularly vulnerable to inward-traveling infection; rejection, in which the body pushes the implant out; migration, in which the implant changes location; and various types of scarring, bubbling, oozing and bruising [sources: BMEzine Encyclopedia,Philips].
Almost all transdermal implants eventually need to come out (typically due to complications, though a necessary MRI would mean removal, too), and getting them out is a lot harder than getting them in. Scar tissue has grown through the anchor base. Removal can mean huge incisions that leave prominent scars, and if inward traveling infection or deep transdermal placement is involved, removal can require major surgery [source: BMEzine Encyclopedia].
Transdermals' risks and poor track record have led to a general sense of ill-advisement in the extreme-mod community, especially with the development of microdermals[source: Philips]. Microdermal implants protrude through the skin but sit on anchors small enough to be implanted using piercing techniques, as opposed to surgery [source: Beyond Body Modification]. They don't support the jewelry sizes seen in some transdermals, though, like the spikes in Joe Aylward's metal mohawk.
As for that groundbreaking implant, it lasted a full decade before Aylward had it removed "for personal reasons" [source: BMEzine Encyclopedia]. All in all, not a bad run.