This item is a refaced mouthpiece, adjusted to approximately the Meyer 5-6MM size. It was refaced by a now-retired repairman in Tokyo. I purchased it used, but I'm selling it to clear out my inventory. I've stored it carefully, but I don't see myself using it in the future, so I'm reluctantly selling it. Please check the photos for the condition. No accessories are included. Only the mouthpiece itself. It will be wrapped in protective packaging for shipping. Please understand that this is a used item and purchase it with the understanding that it is non-refundable and cannot be returned.