There is a large variety of body jewelry available for stretched piercings. Many jewelry materials can be used in the manufacturing of body jewelry for stretched piercings; materials that would ordinarily be too delicate or brittle to be inserted in smaller gauge piercings are freely used. Stone, fossilized materials, wood, bone, horn, amber, bamboo, silicone, and glass are not uncommon in stretched piercings. Many of these materials "breathe" better than metals or plastics, preventing the buildup of sebum in the enlarged ear lobe. Jewelry, however, is still often made of acrylic or metal.

The typical body piercing jewelry worn in a large stretched piercing is a plug. It is solid and usually cylindrical, and may be flared out at one or both ends (saddle-shaped), or kept in place by o-rings fastened around the ends. A variation on this is the flesh tunnel, which is shaped in the same way, but hollow in the middle. Claw-, talon-, and spiral-shaped pieces are also commonplace. Ear-weights in varying degrees of size are also worn, commonly made from silver or bronze, though other metals such as copper or brass are occasionally used. However, some people's piercings are easily irritated by some metals; therefore, care should be taken when body jewelry is worn. Ear cuffs (such as the gold ones utilized in South India provinces) or wrapped bead work (common amongst the Maasai of East Africa) are other options, though are not usually seen in modern Western contexts.

There are several common methods used to enlarge piercings, of various origins and appropriate for different circumstances.

Tapering

The most common professional technique for stretching piercings, piercing tapers involves the use of a taper, a conical rod usually made specifically for this purpose. It is lubricated and pushed through the fistula until the widest part of the taper is level with the skin surrounding the piercing. Larger jewelry is then pushed through, parallel to the back of the taper. Tapers come in a variety of sizes and are usually identified by the gauge of the large end. They can vary in length, but most tapers are about 2-3 inches (approx. 5-7 centimetres). Most tapers are made of surgical steel or acrylic and some have threads extending from the wide end to allow the attachment of barbell jewelry, to make insertion easier. Improvised objects like knitting needles and porcupine quills or cocktail sticks are sometimes used as tapers by people stretching at home; however, this is not recommended by professionals, as their gauge cannot be exactly determined and sterile practices are rarely followed at home.

Dead stretching

Any stretching where no equipment is used and larger body jewelry is forced through an existing piercing. This can lead to two types of injury if the fistula is unready: a simple tear of the skin, or a "blowout" in which the fistula is pushed out through the back of the piercing by pressure. A buildup of scar tissue may be created, which will weaken the fistula and can make it more difficult to stretch in the future. Some piercings will stretch slightly on their own and larger jewelry can be inserted without the potential for unpleasant side effects, especially piercings that see a lot of "play", such as tongue piercings, and those that have loosened to the extent that, when gently pulled on, light can be seen over the top of jewelry being worn.

Teflon tape stretching

The existing jewelry is removed and a thin layer of non-adhesive Teflon tape, which is inert and safe for piercing use, is wrapped around the jewelry. The jewelry is then re-inserted, and as the piercing adapts to the new diameter of jewelry, the process is repeated with the next application of tape being thicker than the previous one. This is done until the fistula has stretched enough to accept new body piercing jewelry altogether. It is highly recommended to use jojoba oil, emu oil, or other moisturizing oils to facilitate this process. This is the safest way to stretch piercings and is recommended by most professionals. Non-adhesive bondage tape is also frequently used.

Weights

Large, heavy jewelry or weighted objects can be used to stretch piercings. This method is not widely used in modern-day, as it tends to cause piercings to migrate and can, especially in ears, lead to a thinning of tissue that is disfiguring or requires reconstructive surgery. However, it is a method that has been traditionally utilized by various tribes, such as the Dayaks in Borneo, that practice extreme earlobe elongation.

Scalpelling

Rather than expanding a healed fistula, this method involves extending the size of the piercing by using a scalpel to cut the edge of the fistula, expanding its diameter. It is often used in earlobe piercings. This technique is also often used to alter the placement of a large piercing.

Scalpel and taper

After an area of flesh is removed (using the scapel method), a large taper can be inserted directly after, allowing skin to instantly be stretched to large diameters; several inches can be achieved. This method is much rarer and can be extremely painful. The use of a dermal punch, followed by tapering, is also used in this procedure but not recommended by professional piercers. Silicone Plugs — These piercing plugs are soft and malleable, allowing a relatively large plug to be inserted into the fistula. Once folded and inserted into the ear, they expand, stretching the earlobe. However, stretching with silicone is often a dangerous decision. Its not recommended to use silicone plugs to stretch with, due to the tacky surface. The stretched fistula can adhere to the silicone, and silicone is airtight, which can trap infection and cause it to spread internally. Also silicone will expand and contract in temperature change. In heat they can swell which can potentially blow out a newly stretched fistula.