This bracelet is especially nice for a surprise gift since you do not need to know their exact wrist measurement. You can add, take out, or move the Italian charms around on the bracelet. I will make the bracelet the size you need plus I will send 3 extra links just in case you need to make it larger. Contact me what size you want. If you do not let me know the size you need I will send a standard 7 inch bracelet. This bracelet comes with the charms as shown attached to a "SHINY" starter bracelet. The small Italian charms and links shown are 9 mm x 10 mm (3/8 inch). The large medical super link charm is twice as long. 9 mm x 20 mm. I also sell an ITALIAN CHARM TOOL which makes it easier to add, take out, or move your charms around on the bracelet. See our “FREQUENTLY ASKED QUESTIONS” for more details.