Lip piercing and lip stretching were historically found in African and American tribal cultures. Body Jewelry of the lip, or labrets, were sported by the Tlingit as well as peoples of Papua New Guinea and Amazonia. Aztecs and Mayans also wore labrets, while the Dogon people of Mali and the Nuba of Ethiopia wore rings. The practice of stretching the lips by piercing them and inserting plates or plugs was found throughout Pre-Columbian Mesoamerica and South America as well as among some of the tribes of the Pacific Northwest and Africa. In some parts of Malawi, it was quite common for women to adorn their lips with a lip disc called a "pelele" that by means of gradual enlargement from childhood could reach several inches of diameter and would eventually alter the occlusion of the jaw. Such lip stretching is still practiced in some places. Women of the Mursi of Ethiopia wear lip rings on occasion that may reach 15 centimetres (5.9 inches) in diameter.

In some Pre-Columbian and North American cultures, labrets were seen as a status symbol. They were the oldest form of high status symbol among the Haida women, though the practice of wearing them died out due to Western influence.

Tongue piercing was practiced by the Aztec, Olmec and Mayan cultures as a ritual symbol. Wall paintings highlight a ritual of the Mayans during which nobility would pierce their tongues with thorns, collecting the blood on bark which would be burned in honor of the Mayan gods. It was also practiced by the Haida, Kwakiutl and Tlingit, as well as the Fakirs and Sufis of the Middle East.