A surface piercing is a piercing which has both its entrance and exit points on a flat plain with 90-degree subcutaneous bends. Microdermal anchors are similar to this, but with only one exit point. Punch and Taper is the most practical method for the installation of these types of piercings.

The Punch & Taper procedure creates a fistula perpendicular to the surface of the skin; then uses a taper to separate the dermis from the connective tissue below, making the path for the jewelry exactly the same shape as the jewelry itself.

The Punch & Taper procedure is the most practical, generally hurts less and reduces healing times.