Ok, I thought you were using Poser since your thread was in the Poser forums. If you're using Photoshop you might want to look at this tutorial on making elf ears on someone.
http://www.graphicaddicts.net/forums/index.php/topic,184.0.html

And this one is a tutorial on how to create a face with freckles.
http://www.alfoart.com/digital_photo_retouching_1.html

I hope these were a help.