Once upon a time, surface piercings were installed the same way as basic body piercings were; with a straight or curved barbell. Over the years this has been proven to be pretty much the worst way to do a surface piercing. There's always an exception to the rule, and in relation to this subject some people have healed surface piercings done this way. Having this style of jewelry in a surface piercing puts pressure on the healing tissue above and its lack of flexibility adds to the amount of stress as tissue moves.

Later, an idea came into play that was meant to eliminate the jewelry issues with surface piercing. That idea was flexible jewelry. This helped decrease the pressure on healing surface piercings, but is still considerably less reliable than proper surface bars.

Proper surface bars are made of implant grade stainless steel or titanium and have a purpendicular design in order to optimize the body's healing process. They are optimally made with internal threading and installed via the punch & taper method; similar to microdermal anchors.