Increasingly large discs (usually circular, and made from clay or wood) are inserted into a pierced hole in either the upper or lower lip, or both, thereby stretching it.

[citation needed] However, because of natural mechanical attributes of human skin, the plate's size may often depend on the stage of stretching of the lip and the wishes of the wearer.

Among the Surma and Mursi people of the lower Omo River valley in Ethiopia,[3] about 6 to 12 months before marriage, a young woman has her lip pierced by her mother or one of her kinswomen, usually at around the age of 15 to 18.

The initial piercing is done as an incision of the lower lip of 1 to 2 cm length, and a simple wooden peg is inserted.

[4] In 1990 Beckwith and Carter claimed that for Mursi and Surma women, the size of their lip plate indicates the number of cattle paid as the bride price.

[6] LaTosky, meanwhile, argues that most Mursi women use lip plates, and the value of the ornamentation lies within a discourse of female strength and self-esteem.

[9] In South America among some Amazonian tribes, young males traditionally have their lips pierced and begin to wear plates when they enter the men's house and leave the world of women.

[12] Among the Haida, Tsimshian, and Tlingit, they were once used by women to symbolize social maturity by indicating a girl's eligibility to be a wife.