I started with this photo from Pixabay, which is a source of copyright-free images. I like the serious gaze of the girl.

I processed the image in iColorama for tone, smoothness, to fix the eyes, and to warp it. I warped her to increase the size of her eyes and forehead, for a more open expression. I used a background from the iColorama background exchange,which you can find here. I think this one was made by Donald Bishop.

I will use this Pixabay image to blend with.

In Effect/Blend, I blended the hand over the face, and used an inverted brush mask to paint in the right eye.

I added in a second hand in Effect/Blend.

In Effect/Blend I now brought in the warped image of the girl without the hands. I reduced opacity so I could place the top image where I wanted it, so that both of her eyes are visible over the right hand. Then I put opacity back to 100%. In Normal blend mode, I opened the Set sliders and pulled the right side of the gray slider almost all the way to the left, to drop out the blue background of the top image. Then I used a brush mask to clean things up.

Then in Effect/Blend, I brought in the image of the girl again, and using an inverted brush mask I painted in some more details in the eyes in the hand on the right.

I painted in a brush mask for the hand on the left.

Using the mask, I added a texture and color to the hand on the left, applied, and removed the mask. Then I toned the overall image using Effect/Glow, Adjust/Levels, and Tone/Duotone.

Using a preset in Texture, and importing the mask of the left hand, I added another texture to the hand on the left, and further toned the overall image using Tone/Lomo.

I painted in a brush mask for the hand on the right

Using the brush mask, I lightened the right hand.

In Effect/Blend, I added in the flower from a Rijksmuseum image. I used Normal blend mode, and I used the gray slider under Set to get rid of the light background around the flower. Then I painted a brush mask to clean it up.

This is the Rijksmuseum flower image that I used.

Now I opened the image in Metabrush and painted in some bubbles. I used a small white brush and a round Gradient brush, with lots of positional variance and spacing.

In Metabrush, I changed the brush color to orange and reduced the size of the brush a bit, and painted in some more bubbles.

Back in iColorama, I darkened the image using Adjust/Shadows.

I applied some Raise for definition.

On the hand on the right, I used Style/Edges to darken the edge, and Style/Flow to smooth out the edge, and an inverted brush mask to limit the Flow effect to the edge.

Here is the brush mask.

I added in a texture from Pixabay.

Here is the texture.

I painted in some subtle highlights using Effect/Light at medium intensity, using a fine brush on an inverted brush mask. I brightened the overall image in Adjust/Levels.