Behind the Scenes of ‘The Pit’: The Bloody and Grotesque FX Makeup Secrets; From Live Maggots to Cream Cheese Skin Grafts

According to the CinemaDrame News Agency, Miriam Arogetti, the head of the makeup and prosthetics department for the hit medical drama The Pit, knew perfectly well that following the massive success of the first season, she had to take much larger leaps for Season 2. If the debut season shocked audiences with realistic heart attacks, third-degree burns, and emergency open-chest surgeries, the challenge for the second season was to push the boundaries of realism even further for the doctors at Pittsburgh Trauma Hospital.

This season, Arogetti worked on another open-chest surgery, a horrific scalp laceration caused by a fireworks explosion, severe chemical-sunburn reactions, and much more. In the second episode, when a patient’s leg cast is removed, viewers are confronted with a stomach-turning cluster of live maggots. “Those maggots were truly gross!” Arogetti shares with a laugh. “But the thrill of shocking people in different ways is what always keeps me hooked.” Speaking with Variety magazine, she pulled back the curtain on the behind-the-scenes secrets of this season’s bloodiest moments.

Live Dissection in the Trauma Center

At the start of a fresh shift, a patient arrives with a kitchen knife embedded in his chest. When his heart stops, Dr. Garcia (played by Alexandra Metz) is forced to perform an immediate emergency thoracotomy. “In FX makeup, we open everything up,” Arogetti explains. “The main challenge was making the skin quality look completely genuine, so we used highly flexible silicones. The torso was entirely prosthetic, but we utilized the actor’s real head and hands as much as possible, using precise camera angling to keep the actual actor hidden beneath the gurney.”

Severe Sunburns from Citrus and Sunlight

In Episode 8, a patient is admitted with severe skin blistering caused by phytophotodermatitis—a harsh chemical reaction triggered by the combination of citrus juice and intense sunlight that results in terrifying blisters. Arogetti confesses that looking at real medical photos to design the look was deeply unsettling even for her: “There were no pre-made prosthetic pieces; everything was hand-painted, which took hours to execute. The blisters were crafted from silicone in various shades and sizes, then airbrushed to add depth. Finally, we used Vaseline and lubricating gel to give the blisters their natural, wet sheen.”

Ghastly Scalp Avulsions

In Episode 12, the character Dante (played by Shane Nelson) suffers severe head trauma and a deep scalp laceration following a fireworks explosion in a warehouse, leaving part of his scalp completely peeled back. “This piece was fitted right onto the actor’s head,” Arogetti says. “We wanted to execute the actual suturing on camera, so there had to be adequate protective backing beneath the silicone skin to ensure the needle wouldn’t poke the actor’s scalp.” Constructing this custom silicone piece, which had to flawlessly match the actor’s head shape and hair color, took six weeks of production.

Glow-in-the-Dark Fluid and Foam Limbs

In Episode 6, Brandon (played by John Squires) arrives with a severe knee injury. To check for nerve damage, doctors inject a fluorescent dye that glows in the dark. Noah Wyle (playing the lead physician) insisted that the plunge of the giant syringe be fully visible in the camera frame. Since doing this on a real leg was impossible, the makeup team quickly fabricated a synthetic leg out of foam. The challenge was that if the glowing fluid soaked into the foam, the entire prosthetic limb would light up in the dark. To counter this, Arogetti engineered a miniature internal channel within the injection path to guide the fluid straight out without leaking into the foam.

Suturing a Synthetic Tongue

For a scene involving a severe tongue laceration, a standard dental retainer was the key to the illusion. The makeup team built multiple synthetic tongues of varying sizes that snapped onto the retainer. This clever trick allowed the actor to move his mouth and realistically react to the surgery while the actors playing the doctors safely sutured the silicone tongue without any risk of injury.

Emergency C-Section and the Cream Cheese Trick

The season finale culminates in a high-stakes, life-threatening delivery. A patient named Nicole suffers a seizure brought on by severe preeclampsia, forcing the medical team into an emergency C-section. The actress spent five hours in the makeup chair for several days to be fitted with a custom prosthetic pregnancy belly and swollen ankles.

To mimic vernix caseosa—the white, creamy protective substance that coats newborn babies—the makeup crew ingeniously utilized cream cheese! “The biggest challenge was that with every single take, the entire setup had to be reset,” Arogetti notes. “We were a team of six or seven people, each with a highly specific task: one person refilled the artificial uterus, another coated the baby in cream cheese, and the next sealed the belly back up for another incision. It was absolutely chaotic, but brilliant!”