Which of the following would be classified as an extreme body modification?

Tongue and penis splitting is classified as an extreme body modification due to the significant alteration it imposes on the body. This practice involves surgical procedures that modify the anatomy in a permanent and drastic way, often requiring a higher level of commitment to the changes being made. Extreme body modifications are characterized by their invasive nature, the potential for serious physical and psychological impact, and their deviation from conventional forms of body art.

In contrast, permanently applied makeup, simple tattoos, and basic ear piercings are considered more common forms of body art. These practices do not fundamentally alter the body's structure or functionality to the same extent as tongue and penis splitting. Rather, they are generally viewed as aesthetic enhancements that can be applied and removed with relative ease compared to extreme modifications.