Many individuals with prosthetic arms and/or legs are amazing athletes. This necklace is of a runner with a prosthetic arm and leg that has been cut by hand from a US coin. If you would the necklace to be of a woman or have just one prosthetic leg or 2 or any other combination then please let us know in your order comments. There will be no extra charge.We have a small team of 6 and we work very hard to make the perfect gifts. We really do cut out coins by hand with a small jewelers saw.