I used size 18 for cartilage. I'll add more over time, but so far I'm satisfied. The needle is very sharp and my jewelry fits well in the needle. Piercing the thick cartilage was minimally painful as the needle was very sharp. If you are planning to pierce yourself or someone else, make sure your jewelry is inserted into the non-pointed end and then pierced. This way you can pull the needle all the way through without trying to insert the jewelry into the hole. Also be careful as the end is very sharp and I accidentally scratched the sink just by running it over my skin.
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