I have attached the skull to the ear cuff with a jump ring, but I also have skull earcuffs with chains available, as well as other sizes:
The skull dangles about 2 cm (around 3/4 of an inch) from the silver plated cuff. These ear cuffs perch on the middle of your ear, not the top.
Click here to see all of my ear cuffs:
All of my pierced earrings can be made as ear cuffs:
PLEASE CLICK to see my holiday order deadlines, if you need your order delivered by December 24th: http://etsy.me/1bFhV3b