Freehand piercing is a technique which negates the need for clamps. Freehand piercing involves massaging the tissue by hand, tenting and then holding and piercing the tissue without the aid of tools. This method is often favoured over clamping because it negates the re-sterilization and use of tools. The marking of the piercing and the jewelry insertion are basically the same as any standard piercing procedure.

Piercing for a suspension is done freehand, but the piercing procedure is slightly varied and quicker than standard piercings. This is commonly called "hook throwing".