A tattooist known as Dr Evil has been handed a 40-month jail term after carrying out ear and nipple removals at the request of two of his customers.
Brendan McCarthy, who also carried out a tongue-splitting procedure at his studio in Wolverhampton, pleaded guilty last month to three counts of causing grievous bodily harm with intent.
Sentencing the 50-year-old, from Bushbury, Wolverhampton, at the city's Crown Court on Thursday, Judge Amjad Nawaz said McCarthy had no qualifications to carry out surgical procedures or to deal with any adverse consequences which could have arisen.
The judge told the body modification artist: "There is a clear public interest element. There is also a need for deterrent."
Several friends of McCarthy cried and comforted each other as he was led away, while he could be heard howling in apparent distress after he was taken from the dock.
McCarthy, who ran Dr Evil's Body Modification Emporium in Princess Alley, Wolverhampton, admitted the charges after the Court of Appeal said his customers' written consent to the procedures did not amount to a defence.
Opening the case against McCarthy, prosecutor Peter Grieves-Smith QC said of the tattooist's guilty pleas: "The prosecution have accepted that the customers in this case consented to the procedures performed by the defendant.
"That involved the removal of an ear, secondly the division of a tongue to create a forked tongue, and thirdly the removal of a nipple."
Customer Ezechiel Lott, whose ear was removed in 2015, had been contacted by police after McCarthy pleaded guilty, the court heard.
In comments to police, read into the record by Mr Grieves-Smith, Mr Lott said he "felt like he had been deceived" as he thought at the time that the procedure was legal.
Mr Grieves-Smith said: "He stated that had he known it was illegal, he would never have had the procedure because he certainly was not that desperate to have his ear removed."
Defence QC Andrew Smith had urged Judge Nawaz not to jail McCarthy – who now has "no direct engagement with customers" – in the "unusual" case.
Mr Smith said: "I accept that the conduct Mr McCarthy has pleaded guilty to must cross the custodial threshold.
"But nevertheless in the exceptional circumstances of this case, the court could properly suspend any such sentence."
Accepting that McCarthy had caused harm, Mr Smith added: "Each individual actively sought the procedures. It came about as an extension of the work he had historically undertaken in respect of body-piercing and tattooing.
"The defendant is plainly remorseful... expressed through pleas of guilty and expressed in his discussion with the Probation Service."
Earlier, court hearings were told the ear removal was performed in 2015 without anaesthetic, three years after McCarthy split a woman's tongue with a scalpel.
McCarthy first appeared at Wolverhampton Crown Court in 2017, when he initially denied six counts relating to the three procedures.
Following a failed bid to convince a Crown Court judge that consent was a lawful defence, McCarthy took his case to the Court of Appeal, contending that the procedures should be regarded as lawful to protect the "personal autonomy" of his customers.
But three Court of Appeal judges, who noted that McCarthy had divided a customer's tongue "to produce an effect similar to that enjoyed by reptiles", said the procedures were not comparable to tattoos and piercings.
Although they accepted evidence that the ear removal had been "done quite well" the judges said it was not in the public interest that a person could wound another for no good reason.
In a statement issued after McCarthy pleaded guilty, Wolverhampton City Council said public protection officers had served a notice preventing him from carrying out extreme services.
An online petition set up to support the "knowledgeable, skilful and hygienic" body-piercer, who was refused permission to appeal to the Supreme Court, attracted around 13,000 signatures.
Commenting on the prosecution last month, Councillor Steve Evans, Wolverhampton's Cabinet Member for City Environment, said it exposed the requirement for national regulations protecting members of the public against the risks of extreme body modification.
"Whilst I'm sure Mr McCarthy considers himself an artist, providing a service removing and cutting people's body parts without adequate medical training from unsuitable retail premises, presents a risk to the public that we are not prepared to accept," Mr Evans said.