How large are you wanting to go?
Looks great!
I'm an on-point person, so will agree with you on that!
What I would do now would be to slap it onto my design wall and start playing.
Or lay it on a bed, as that let's you lay yardages out easy to get a sense of what might work (or not!).
Another way is to take your photo and start doodling with it as to the possibilities.
My first thoughts are for a bit more white, maybe just an inch or two of border/sashing
to let your medallion float before adding anything else.
Have fun ... I love the crisp fresh look of it right now!