Freehand piercing is piercing performed without the aid of clamps. The skin is massaged, then tented up by hand and pierced without being held with any tools (the exception being an occasional Receiving Tube). Some piercers prefer this because of the direct "feel" it provides, although it can increase the chances of a needlestick.
Freehand piercings are still marked like a normal piercing; other than the omission of clamps, the procedure is basically the same. Most body piercing is not performed freehand, although in certain instances, such as when placing flesh hooks, it is still the norm.