Frame and headgear not included.
About this part
The cushion does the actual sealing work on the mask, and it's a consumable by design. ResMed's dual-wall Spring Air cushion has a soft outer membrane that conforms to the face and a self-adjusting inner wall that holds the seal as you move — but silicone softens, stretches, and loses its shape with nightly use, facial oils, and repeated washing.