I was going to go wireless, but after I bought my Aker, I decided not to. It is wired, but it is pretty easy to drop the wire down the neckseal and suit and then you don't have to worry about connecting the bluetooth or making sure it is charged... just one less thing to go wrong.
You can hand it around your neck, but I actually put the Aker in my left hip pocket. Nobody can really tell where your voice is coming from anyway. I haven't cut a hole in my flight suit for the wire. I just wire it from the bottom of the flight suit zipper to the hip pocket and nobody notices, though I probably could cut a hole so that nobody can see any wires. I thought everyone was doing this wirelessly, but it turns out that I think most people go wired.