comes in a piercing device [SEP] exactly as listed but i do not recommend these for the actual piercing with the device the earrings are in the cartridge upside down by being upside down it makes it next to impossible to pierce ears with i finally got the first one to go in but it was crooked and the second one top one i tried for minutes before i could get it into position and it went in sideways shallow barely under the surface of my skin it hurt sooooo badly it was all i could do to muster up the courage to get it out then i took the first hoop back out also after about minutes of using ice on my ear putting peroxide on it it finally quit bleeding so i just pushed them through by hand since my ear was already numb from the ice i will never purchase these again do not recommend for upper lobe piercings they may work okay for lower lobe area the normal piercing spot but it ll hafta be done upside down or at a weird angle so just be aware of that not sure if studex has any suggestions on successful piercings with these or not if so perhaps they can post a video