This is an illustrious gold labret monroe lip ring made from high grade solid TITANIUM 6ALV-ELI (Grade 23) IMPLANT GRADE. It comes with your choice of a 4mm ball or a 5mm ball. The comfortable flat end measures 4mm. The size is 14 gauge and your choice of 6mm-1/4, 8mm-5/16, 10mm-3/8, or 12mm-1/2 of an inch. The entire piece is nickel free.