After six months of stretching, the lip is so elastic that a plate can be slipped in and out without difficulty. The plates must always be worn in front of men and can only be taken out at private mealtimes, when sleeping, or in the presence of other women. Unlike lip plates, clay ear plugs are worn by both young girls and women for decoration alone. The Surma live primarily on a diet of milk and blood, seasonally supplemented by maize millet. An arrow is shot a quarter of an inch into the jugular vein of a young heifer to obtain just enough blood to fill a calabash.
Young boys drink blood to grow, and men to gain strength.