Though the Prince Albert piercing and reverse Prince Albert piercing (also simply called a reverse PA) have similar names, they are actually very different. While the Prince Albert goes through a small amount of tissue and is quick to heal, the reverse PA is—essentially—an apadravya piercing, without the Prince Albert. This means that the piercing enters on the top side of the penis (usually centered) and exits out the urethral opening. It also means that the healing time for a reverse PA is quite a bit longer than for a Prince Albert (four to six months as compared to six to eight weeks for a regular PA).

Because of the difficulty in healing this piercing with a ring, we often recommend you start with an apadravya piercing; you can then switch where a ring in the top piercing after healing. That being said, if a reverse PA is the desired outcome, the piercing will often be done closer to the tip of the glans than with a regular apadravya piercing, so the ring worn will not need to be too large, and therefore too unwieldy. Be sure to discuss your intentions with your piercer to ensure you get the best possible piercing for you, your anatomy, and your lifestyle.