I have seen similar stuff on Taboo on the Leaning Channel. there are NO plastic surgeons! This is a person who does this sort of thing for people out of his home or his tattoo shop. They have learned by trial and error. They boil the instruments and implants. Some have a some medical instrument sterilizer that can be purchased on Ebay. The implants care available on line. Oh, yes, I should mention they do not use any anesthesia at the site! They grit their teeth and go through the pain!!!