In most cases, yes, you’ll be asked to remove body piercings before surgery. But the rules aren’t as rigid as they used to be. Updated guidelines from the Association of periOperative Registered Nurses (AORN) note that modern surgical equipment has reduced many of the risks that once made jewelry removal a hard rule. If a piercing can’t be removed, your surgical team should assess the specific risks and consider alternatives rather than canceling or forcing the issue.
That said, there are real reasons hospitals ask you to take piercings out, and understanding them helps you prepare and protect your piercings in the process.
Why Surgical Teams Ask for Removal
The concerns fall into a few categories, and not all of them apply to every surgery.
Burns from surgical tools. Surgeons frequently use electrosurgical devices to cut tissue and stop bleeding. When the active electrode directly contacts metal jewelry, the tissue around the piercing can heat up dramatically, with one study on animal tissue measuring a temperature spike of over 47°C at the point of contact. At a distance of just 5 to 10 mm from the jewelry, though, the temperature increase dropped to less than 5°C. So the risk is highly location-dependent. A navel piercing during knee surgery isn’t the same concern as a navel piercing during abdominal surgery.
Airway risks from oral piercings. Tongue, lip, and cheek piercings pose a unique problem during general anesthesia. When a breathing tube is placed down your throat, loose jewelry can dislodge and be inhaled into the lungs or cause dental damage. Swelling of the tongue during long procedures can also turn a snug-fitting barbell into a choking hazard. Oral piercings are the ones surgical teams are least flexible about keeping in.
Pressure injuries during long procedures. Surgery can last hours, and you’ll be positioned on a firm table without the ability to shift your weight. A piercing pressed between your body and the table, or between your body and a positioning device, can cut off blood flow to that patch of skin. This can cause pressure-related tissue damage, especially in areas with thin skin or limited padding.
Imaging interference. If your surgery involves intraoperative imaging, or if you need an MRI before or after, metal piercings can be a problem. Magnetic metals experience force inside an MRI scanner and can shift or heat up. Even for X-rays and CT scans, metal jewelry creates artifacts that obscure the image your surgeon needs to see.
What the Current Guidelines Say
Older protocols treated jewelry removal as non-negotiable. The updated AORN guideline takes a more nuanced position. A review of the evidence found no definitive cases of alternate-site burns linked to jewelry during standard electrosurgery with modern equipment. The recommendation now is a three-step approach: notify the surgical team that jewelry is present, evaluate the risks and benefits of keeping it in place for that specific procedure, and consider alternative energy sources (like a battery-powered cautery tool) if the piercing stays.
This doesn’t mean you can show up and assume everything will be fine. It means there’s room for a conversation, especially when removing a piercing would cause it to close or when the piercing is nowhere near the surgical site.
Non-Metal Retainers as a Workaround
If you’re worried about a piercing closing during surgery, non-metal retainers are the standard solution. These are small, often clear or skin-toned pieces that keep the hole open without introducing the risks of metal. The best options for medical settings are:
- Glass retainers: Non-porous, safe for long-term wear, and can even be used as initial jewelry in a fresh piercing. Glass doesn’t conduct electricity or interfere with imaging.
- PTFE retainers: A flexible plastic specifically suited for medical procedures. PTFE can be autoclaved for sterilization, which makes it acceptable in sterile surgical environments.
- Implant-grade silicone: Flexible, blends with skin tones, and safe for extended wear. Non-porous like glass.
- Acrylic or bioflex: Affordable and functional but meant for short-term use only. Fine for a single surgical procedure but not ideal if you need to keep them in during recovery.
Visit your piercer before your surgery date. They can swap your jewelry for a retainer and make sure it’s properly sized. Don’t try to force a retainer into a piercing you’ve never changed before, especially a newer one.
How Fast Piercings Close
The fear of losing a piercing is legitimate. How quickly a hole closes depends on the location, how long you’ve had it, and your body’s healing tendencies. Newer piercings close faster because the channel (called a fistula) hasn’t fully matured. Here’s a rough guide to initial healing times, which gives you a sense of how established the channel is:
- Earlobes, eyebrows, lips: 6 to 8 weeks to heal
- Tongue or inner mouth: 3 to 6 weeks
- Ear cartilage: 2 to 4 months
- Nostril: 2 to 8 months
- Navel: Up to 9 months
- Nipples and genital piercings: 6 to 12 months
If your piercing is still within its healing window, removing jewelry even for a few hours can mean partial or full closure. A well-established piercing that’s years old may tolerate several hours without jewelry, but cartilage and navel piercings can begin shrinking surprisingly fast regardless of age. The safest approach is always a retainer rather than leaving the hole empty.
What to Do Before Your Surgery
Bring up your piercings during your pre-operative appointment, not the morning of surgery. Your anesthesiologist and surgeon need to know the locations so they can assess whether the piercings are near the surgical site, the airway, or imaging areas. If you arrive on the day of surgery with a piercing no one knew about, you may face a last-minute scramble or an uncomfortable removal.
For piercings you can easily remove yourself, take them out at home the morning of surgery and store them safely. For piercings that are difficult to remove, or ones you want to swap for retainers, visit your piercer a few days ahead. Some piercings use internally threaded or press-fit jewelry that’s tricky to remove without the right tools.
If you have a fresh piercing that hasn’t healed and your surgery is elective, mention the timing to your surgeon’s office. They may recommend waiting, or they may clear you with a retainer in place. For emergency surgery, the team will handle jewelry as needed, and preserving a piercing will understandably be a low priority.