Ethan Bramble has been doing modifications since he was 11. Photo / Instagram
WARNING: Graphic content.
A week after a "body modification expert" was charged with female genital mutilation, authorities have vowed to crack down on the "grey area" industry.
In an interview with The Daily Telegraph, NSW Health Minister Brad Hazzard called the body modification industry "the worst barbarism imaginable", target="_blank">news.com.au reports.
"This so-called body modification is just plain wacko and can lead to permanent maiming," Mr Hazzard said.
"My view is these people are ruthlessly opportunistic. This is up there with the worst barbarism imaginable."
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Mr Hazzard's comments come a week after Brendan Russell, from the NSW Central Coast, was arrested in his home and charged with mutilating a female's genitalia in 2016. News.com.au understands the cops were responding to a complaint from a customer who allegedly underwent a botched labia reduction.
Better known as a labiaplasty, it's a procedure normally done by a plastic surgeon that involves cutting or reducing the size of the folds of skin that surround the vagina.
A now-deleted Instagram profile for the 37-year-old body modification artist said he had 10 years' experience in the field and showed off the work he'd previously done.
Photographs of split tongues, ears sliced to resemble an elf's and implants placed into people's heads and hands to resemble horns and scarab beetles were all uploaded to the account.
So, why do people voluntarily submit to these surgeries?
Ethan Bramble, 21, lives on the NSW Central Coast and calls himself the "world's most modified youth" after undergoing more than 40 body-modification procedures and sporting about 150 tattoos.
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The 21-year-old has more than 65,000 followers across Facebook and Instagram, many of whom are obsessed with his look.
Mr Bramble has spent the better part of a decade hanging out in tattoo shops and has been working in the tattoo, piercing and body modification industry since he was 13.
The 21-year-old first started modification with stretchers in his ears when he was 11 and admitted he had an "obsession" with tattooing.
By the age of 17, he started looking into heavy modification because he "liked the way it looks".
Four years later, Ethan has had his tongue split, his philtrum (the indented top part of the lip) cut and stretched, his labret (the area under the bottom lip) cut and stretched which has now been sewn up.
He's had his nostrils punched (a procedure done with a cookie-cutter-type tool), his ears have been stretched, the insides of his ears have been punched and each ear has been cut and shaped so half is missing.
He has also had his eyeballs tattooed and his bellybutton removed.
When asked by people why he wants to look the way he does, Mr Bramble said it came down to the look.
"Girls especially come up to me on the street and ask, 'Why? Just why?'" he said.
"And I ask, 'Why do you dye your hair? Why do you put makeup on in the morning, why do you paint your fingernails?'
"It's the way you want to look, your appearance and I've always been a strong believer in you shouldn't really judge people in the way they look.
"The end product is 100 per cent worth the torment, if you're committed to it."
Mr Bramble had his tongue split when he was 17 and said it was "the most intense, f**king modification" he's ever done.
In the days after the procedure, he was unable to eat or drink and even tried crushing up anti-inflammatory pills and attempting to take them with a baby syringe.
"It was five days of near-death. You have to sleep upright and have a towel because you're constantly drooling and if you lie down you choke on your own spit and saliva and blood and die. It definitely was not a fun experience," he said.
The 21-year-old said his belly button removal, which was done so he could get a stomach tattoo, was a particularly "full-on experience".
"He cut my navel out in a big circle and all of my umbilical cord and told me to sit up and have a look. I could see my stomach lining every time I flexed or breathed sort of protruding out of this hole. It was weird, to see the inside of yourself," he said.
Mr Bramble also said his eyeball tattoos were particularly weird and described it as the "scariest thing" he's ever done.
"To see a syringe come into your eye and enter your eyeball. It doesn't hurt, because there's no pain receptors so it's a really surreal feeling.
"You have one person holding your eyelids open and it's up to you to stare at the wall at a certain spot. It's so stressful because if you move your eyeball when there's a syringe in there, you'll go blind. So that's definitely a really sketchy one."
While some studies link body modification with disorders such body dysmorphia, everyone has different reasons for changing their bodies.
A study from the University of Goettingen in Germany found there were 10 general psychological reasons for people modifying their bodies. Some used it to express spiritual enlightenment, resistance or rebellion. Others seek to build up their pain thresholds, seeing as body modification is usually done without anaesthesia. Others use body modification to express their love of art or their sexuality.
Mr Bramble is used to being judged harshly because of his look, but he said it was after his eyeball tattoos, done with black ink, that people really started to shrink away from him.
"People's perceptions of you change a lot," he said. "You walk down the street and people cross the street to get away from you or think you're really scary or something.
"That first impression is everything so even if you just see me and you're looking at me trying to sus me out, your first impression is going to be 'I'm f**king terrified'. I'm a weird looking dude," he added.
As far as heavy modification goes, the only things Mr Bramble is not interested in doing is genital mutilation or removing his nipples β procedures that other body modifiers seek out.
"I've done everything that appeals to me and I enjoy my member so cutting it in half is probably something I don't really want to do," he said.
"The people that come in to get it done are the last people you'd expect. They're like older gentlemen and maybe it's like a clique thing because it's normally people that work in offices and wear suits all day and have a nine-to-five job that have these [procedures] done.
The body modification industry is a new one which means the laws are yet to catch up to the largely unregulated procedures.
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Last week, NSW Police confirmed that "there is currently no legislation for body modification in NSW however members of the so-called skin penetration industry are required to follow public health regulations".
The only specifically illegal part of the body modification industry is the use of anaesthesia, a drug that is only supposed to be obtained and used by a registered anaesthetist.
Mr Bramble said many body modification procedures would be "impossible" without some form of anaesthesia.
"Some mod artists still use [anaesthesia] and stuff which is illegal but when you think about a lot of my work β I've had ears partially cut off, my tongue cut in half, my bellybutton done, stuff shoved in my skin. Getting it done without any kind of local anaesthetic is borderline impossible," he said.
Mr Bramble fears last week's accusations would do damage to the whole industry.
"It's definitely going to f**k with the modification industry a little bit. Since all of this has come to light, there's going to be a lot more regulation and rules brought in," Mr Bramble told news.com.au. "But a lot of rules have to get broken to do these sort of things.
"It's a massive grey area, modification, because it hasn't been around or in the light for so long. It's a really new thing.
"It's just a shame that through that s**t they're going to crack down on the industry, which is really inconvenient."
The average age of patients in the study was just 38, highlighting risks for younger adults.