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An angel bite piercing is a double piercing with each one sitting symmetrically just above your upper lip on either side of your philtrum —the grooved space between your nose and lips.

It’s sometimes called a Madonna Monroe piercing because it combines the Madonna and Monroe piercings, which are named after Madonna and Marilyn Monroe’s signature moles.

Every piercing appointment begins with a consultation to go over the type of piercing you want and the jewelry you’d like. You’ll also be asked to fill out some paperwork, including a waiver.

Once that’s done, here are the next steps:

  1. Your piercer will clean and disinfect the area using a special product, like a surgical scrub.
  2. You’ll rinse your mouth out with an antibacterial mouthwash to remove any potentially harmful bacteria.
  3. Next, they’ll mark the areas for the piercing with a body-safe marker and confirm that you’re happy with the placement.
  4. Your piercer will use a clamp to gently pull your upper lip away from your gums and teeth.
  5. The needle is pushed through the inside of your lip to the outside and the jewelry is immediately inserted and fastened.
  6. Your piercer will clean the area again.
  7. You’ll receive aftercare instructions.

Yep, but pain is subjective so it’s hard to say exactly how much.

Based on anecdotal reports, people say the rate the pain as being anywhere from 3 to 5 on a pain scale from 1 to 10.

Having an experienced piercer and making sure you’re relaxed for the procedure can help make things less painful.

You can expect some pain, swelling, and possibly bruising for the first 3 to 5 days.

Labret studs are the most common type of jewelry used for angel bite piercings.

The flat discs rest on the inside of your mouth, leaving the decorative end — usually a ball or a gemstone adornment — sitting flat on the skin above your lip.

Any other style of jewelry without a flat disc could irritate or injure your teeth and gums.

You can find jewelry for angel bite piercings made from all kinds of materials, but they’re not all good.

Quality, body-safe materials can help prevent complications like allergic reactions or tissue damage. Stick with jewelry made from materials recommended by the Association of Professional Piercers (APP).

These include:

  • Surgical steel. Surgical steel is affordable and durable. Keep in mind that it contains other alloys, like nickel, if you have a nickel allergy.
  • Implant-grade titanium. Titanium costs more than steel, but it’s lighter and less likely to cause irritation in people with sensitive skin. It’s also completely nickel-free.
  • 14-karat gold or higher. Steer clear of gold-plated jewelry because it contains other alloys and can flake. Stick with 14k or higher, which is nickel-free and biocompatible.
  • Biocompatible polymers (plastics). Jewelry made from polymers like PTFE and Bioplast is biocompatible and flexible. This makes them a good option for piercings like the angel bite because they’re easier on the gums and teeth.

The cost varies depending on factors like your location, experience of the piercer, and the jewelry you choose.

Based on these factors, an angel bite piercing typically runs between around $60 and $120.

FYI: That doesn’t include the tip, so be sure to factor in an extra 20 percent, which is customary.

There’s some risk associated with any procedure that punctures tissue and the location of the angel bite piercing adds a couple extra potential issues to the list.

Having an experienced piercer and following proper aftercare can significantly minimize these.

Possible complications and side effects to watch for include:

  • Infection. Oral piercings are more prone to infection than other piercings because bacteria can get in after eating, touching your mouth, and from kissing and oral sex. Blood-borne infections, like HIV and tetanus, are also possible if unclean equipment is used.
  • Tooth or gum damage. The jewelry rubs against the surface of your gums and teeth when you talk or eat. This can damage your tooth enamel, causing erosion and gingivitis.
  • Swelling. You can expect swelling in the first few days. Applying ice and sleeping with your head elevated can help.
  • Trauma/tearing. There’s a good chance you’ll bump or snag your jewelry if you’re not careful. Be extra cautious when pulling a sweater over your head, styling long hair, or engaging in an especially enthusiastic make-out sesh to avoid tearing.
  • Nerve disruption. While the risk of this is pretty low, a small 2011 study linked facial piercings to nerve disruption. In the four subjects included in the study, facial piercings resulted in chronic back pain and eye misalignment.

Lip piercings typically take between 2 to 3 months to heal. That said, everyone is different and several factors can influence how well or quickly you heal.

These include things like your overall state of health, how well you care for the piercing, and the skill of the piercer.

Proper aftercare is crucial for healing your piercings and reducing the risk for complications.

During the healing process, DO:

  • Rinse your mouth with saline solution or mouth rinse for 30 seconds when you wake up, after you eat, and before bed.
  • Spray or rinse the outside of your piercings with saline solution or gently with a piece of gauze soaked in saline solution.
  • Wash your hands thoroughly before cleaning or handling your piercing.
  • Practice good oral hygiene, including regular brushing and daily flossing.
  • Use a new, soft-bristled toothbrush and keep it in a clean place away from other toothbrushes.
  • Use only mild soap and water on the area, once or twice a day.
  • Rinse well after washing and gently pat dry using clean paper towel.
  • Sleep with your head elevated to help reduce swelling.

During the healing process, DON’T:

  • Touch your piercing with unclean hands.
  • Play with your jewelry.
  • Talk too much when your piercing is new because it can damage tissue and lead to scarring.
  • Eat foods that can irritate your oral tissue, like those that are spicy, crunchy, or acidic.
  • Chew on gum, fingernails, pencils, or anything else that can harbor bacteria.
  • Use alcohol — not even in mouthwash — because it’s irritating and can delay healing.
  • Smoke, which can delay healing and increases the risk for complications. If you can’t avoid it entirely, try to cut back as much as you can.
  • Engage in any type of oral sexual contact, including kissing, even with a monogamous partner.
  • Share dishes or utensils with others.
  • Submerge the pierced area in pools or hot tubs, or bodies of water like lakes, oceans, etc.
  • Remove your jewelry before it’s completely healed.

Some pain, swelling, and even a little bleeding are pretty much a given after piercing tissue. This should improve over the first few days. Anything else could be a sign of a problem, like infection.

See your piercer or a healthcare provider if you notice:

  • severe swelling
  • intense pain
  • severe redness
  • discharge that’s thick, yellow or green, or smells bad
  • gum or tooth issues, such as erosion or bleeding
  • fever, chills, vomiting, dizziness, or confusion

Wait until you’re completely healed to remove or swap out your jewelry. Not sure you’re healed or need to remove it sooner because of a dental procedure? See your piercer for advice or have them do it for you.

Once healed, you can change the jewelry yourself. If it’s stubborn and hard to remove, see your piercer because they’ve got the experience — not to mention the tools — to do it safely.

Don’t take out your jewelry until the piercing’s fully healed — even if you hate it.

Once it’s healed, though, you can just remove the jewelry. Make sure to keep the area clean while you wait for it to close.

You can expect a small scar at the site of each piercing once the tissue grows in.

Ready to make it happen? First, do some research to find a reputable and experienced piercer and a professional studio with good reviews and a solid reputation for safety.

You can ask for referrals from friends or family that have piercings or use the APP members’ directory to find a piercer in your area.

Before booking your appointment with a potential piercer, visit the studio in person and:

  • confirm they have a license/permit to operate
  • ask about their sterilization process
  • check for cleanliness and professionalism
  • ask to see credentials and a portfolio, including pictures of client’s healed piercings
  • check the quality of the jewelry they stock

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.