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The performer swallows needles and a piece of thread. Then, having had his mouth examined and proven empty, regurgitates the needles threaded!
This particular version has all the nice moments that make the effect powerful, such as having a single needle placed on your tongue and cleanly swallowing it, while being fully self-contained: the performer starts and ends perfectly clean, working out of a matchbox.
[Warning: this effect does require putting needles in your mouth (?!); perform it at your own risk.]