Soon after sunrise on the Thai island of Phuket, a swordsman chants an incantation and slowly slides the first of three blades through the right cheek of the woman sitting calmly below him.
Soon, blood is dripping off her face, and red-stained tissues are scattered over the ground.
The ceremony at the October 2-11 vegetarian festival in Phuket's old town aims to cleanse "sinful" souls. Sirinnicha Thampradit, 29, is believed to be a medium that a god has selected to bridge the connection between human and divine.
"I felt weak, I felt numb and I couldn't control anything," Sirinnicha, who woke before dawn to prepare for the ceremony, told AFP.
"One minute I was crying, another I was laughing," she said, adding that possession usually happens during the annual vegetarian festival.
Despite the blood, Sirinnicha, who has a 1.5-inch scar visible on both cheeks from her previous piercings, said she felt no pain during the procedure.
"It's because I 100 percent believe in god, and he has been protecting me for more than 10 years," she said, recalling the hours-long ordeal when a god possessed her for the first time when she was 17 years old.
The wounds heal on their own within seven days, said Sirinnicha, who believes all her family members have been chosen as mediums.
The ceremony, known internationally for its graphic piercings, is held inside the Jor Soo Gong Naka shrine in honour of the "Nine Emperor Gods" in the Taoist religion.
Participants shun meat and other indulgences, such as gambling and alcohol, to purify their bodies before offering them to deities.
The event, which generated more than nine billion baht ($272 million) in 2023 according to Phuket's tourism body, draws hundreds of thousands of visitors each year.
"Piercing is the gods' command, and these objects represent their supernatural power," Kaweepiphat Thomya, the shrine's mediums coordinator, told AFP.
"The body needs to be pierced for suffering to get rid of bad deeds," he said, adding that mediums are the gods' 'chosen ones'.
For mediums, the piercings are an act of sacrifice and the manifestation of the gods' loyalty.
Traditionally, weapons like knives, needles and swords are used to conduct the facial skewerings.
Extreme perforation in recent years has sparked concerns from the shrine association, which warned the public to be cautious of their hygiene to prevent infection.
The kingdom's Ministry of Health has reported rare injuries from extreme piercings, while the shrine has mobilised around 20 medical staff to ensure safety in the ceremony, which dates back to the early 1800s.
"We have been campaigning against unconventional items for piercing, mostly for safety purposes," Karuna Paikaew, the official in charge of the ceremony told AFP.
Once her piercing was completed, Sirinnicha embraced two friends and prepared to walk home, the scar on her cheeks a reminder of her devotion to one of the nine gods.
"My god has chosen me and I sacrifice my body to him once a year," she said.
"I am so proud."
