This lovely bracelet is genuinely crafted with silver beads between a double thickness silver bar and a 1/2 inch by 1/2 inch silver heart charm with a red ribbon and the word "Survivor". These are bracelets for people who are fighting diseases and facing challenges every day of their lives. The sterling silver plated bracelet is 7 1/2 inches with a toggle clasp and has elastic so it stretches to fit most any size wrist.