The process of stretching a piercing to accommodate larger jewelry is sometimes incorrectly called "gauging," but the word gauge actually refers to the size of the jewelry. One of the most commonly stretched piercings is the earlobe. It is possible to pierce the ears at a large gauge and stretch them immediately with a taper, although for best results and minimal tissue trauma, stretching should be done slowly over time. Always look for a piercer certified by the Association of Professional Piercers who has been properly trained in sterilization and cross-contamination procedure.

Eat something at least two hours before your piercing, and refrain from drinking alcohol or taking aspirin, which can thin the blood. A large-gauge piercing and stretch is a bloody procedure, and you want to keep it from being even bloodier.

Visit a professional piercer for a large-gauge initial piercing. Ask the piercer to pierce you with a 6-gauge needle and stretch to a 4 gauge. These are not common needle sizes to keep in stock; your piercer may have to order them and schedule an appointment for you to come back later.

Make sure you see your piercer remove all tools, including needles and jewelry, from autoclave bags or a cassette autoclave such as a Statim.

Prepare for marking to take a while. Your piercer will want to make sure your jewelry will align properly, which is especially crucial with large-gauge piercings. Do not be surprised if the preparation for the piercing takes 1/2 hour. Do your best to focus on your breathing and remain calm.

Sit very still, take a deep breath and exhale as your piercer pushes the needle through. He will leave the needle in your ear while he lubricates the taper and inserts it into the end of the piercing needle. The needles used for body piercing are called cannula needles, which means they are hollow inside. The small end of the taper is inserted into the cannula, and the piercee is asked to take another deep breath. On the second exhale, the piercer will push the needle out and the taper through, completing the stretch.

Be aware that jewelry insertion into a newly stretched piercing is a delicate procedure and prepare for a bit of discomfort. Your piercer will leave the wide end of the taper in your ear momentarily as he disposes of the needle in a sharps container. He will then hold the jewelry, usually a hollow surgical steel plug called a tunnel, against the wide end of the taper. As he pulls the taper out, he will push the jewelry in. This can be the most uncomfortable part of the procedure; stay calm and it will be over quickly.

Be diligent about caring for your new piercing. Cover your pillow with a clean pillowcase every night for the first few nights, as bleeding will likely occur. Soak the piercing twice daily, for 15 minutes each time, in a solution of 1/4 teaspoon noniodized sea salt to 1 cup warm water. Use disposable cups and throw them away after each use. After the salt water soak, wash your ears gently with warm water and an unscented antimicrobial soap like Satin or Provon.