Paying with my hand (yes, that question again) šŸ˜

Custom needle ( normally ) it depends on the form factor, but that will likely be it.

It could also be done with a scalpel to make the incision, and then another tool to make the cavity, the implant is then inserted, and closed up with a stitch or two, or possibly an adhesive.

It all comes down to what the installer is comfortable with and what they can legally do.

Here are a couple of videos that should answer your questions

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