The Nuance Pro frame is made of flexible clear silicone. It includes gel pads at the cheek area of the frame to cushion the area. The gel pads are permanently attached to the silicone frame and cannot be removed. The headgear is designed with Velcro closure tabs which attach to slots in the silicone frame. Small, medium, and large pillows are included. Please Note: The silicone frame with gel pads used with the Nuance Pro is not compatible with the Nuance headgear.