Thanks everyone. When I put the antler in the grip I was wanting something to help with constant hand placement. When I inlayed it I let it stick up slightly above the rest of the grip. As far as a how to this was my first try at something like it. I'm not sure I would even be able to pull it off again. I cut out the shape on a piece of thin maple. I put it in the grip and rounded it with a dremal. After it was done I stippled the grip.
Here is a little better pic of it.