Very flat (doesn't poke out on my nose like other nose rings) and small I loved it and have not been able to find one like it w/out the twist. It was hard for me to get it in and get it out since it was a twist and it looked like I had a booger in my nose. other then that I loved it. Maybe my issues where because I did not know how to properly put it in but I would defiantly recommend it. Especially for work and if you do not want something big/appear big on your nose.