Eventually the shifting of nerves stops. Sadde swallows, then starts pushing the horns against the skin again. She shapes them to be a bit sharper, so they'll cut skin more easily, and eventually two spots of blood appear, and expand, ripping open with a very unappealing sound (to humans) as the little bone horns manage to emerge.

"...this feels really weird," she says, her eyes still closed, and blood trailing down her face. There is in fact quite a lot of blood. Head wounds are known for bleeding more than their severity calls for but wow.