According to Prime Health Channel, back dimple dermals are microdermal piercings placed in the dimples of the lower back, just above the buttocks. A microdermal piercing is made by perforating the subdermal skin layer.
To make a back dimple dermal, a piercing artist creates two holes in the dimple. Then he inserts a surgical needle through one hole and pulls it out through the other hole. The foot of the jewelry is inserted through the two holes. The skin heals to hold the jewelry in place, and the back dimple dermal can only be removed surgically by a medical professional. A person with back dimple dermals should clean the piercings regularly and avoid sleeping on hard surfaces.