The vast majority of Madison piercings will reject or migrate. In a three year, informal study  by the Association of Professional Piercers, out of twelve participants with Madison Piercings, nine were removed due to migration during the first year and the remaining three had not healed. At the end of the three year study, only one piercing had healed and was still worn. Poorly healed, migrating or rejected piercings can cause scarring. Initial jewelry for a Madison Piercing is usually a surface bar, although flexible barbell style jewelry may also be used. It is not unheard for these piercings to be performed with captive bead rings, although this will almost always lead to migration and rejection.