Does the small size come exactly like the picture?

No. To achieve the picture, you also have to buy the Full Face Mask

Does the large come with the frame or just the headgear strap?

You can order just the face cushion or the headgear. However, you can order the full face mask that should include the cushion, headgear and frame. It should say in the product description what all is included. Looks like you will need to google Fisher and Paykel Simplus Cpap mask to find a distributor in order to get the frame. Try Cpapdirect.com as you can get frame, cushion and headgear together for $135 and you don't need a prescription there.

How much difference in size of small and medium simplus head gear

I don’t know. I have always used small mask.

Does the small come with the frame or just the headgear strap?

You can buy the cushion separately. Thus purchase was just for the headgear. I buy separate parts because the headgear and cushion are about the only parts that need replacing and I can get them for $25 a piece without a prescription.

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Simplus Replacement Headgear

Product ID: 463435645

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Description

Specifications

Brand	Fisher & Paykel
Model number	8542030003
Item Weight	50 g
Package Dimensions	19.2 x 15.9 x 7.11 cm; 50 Grams
Item model number	8542030003
Are batteries included?	No

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