step 1 of 9

- : source
step 2 of 9
I erased her original shoulder, and replaced the new one with the eraser tool. I followed the same procedure in Step 1 to achieve the same color.
I also changed the canvas size for more room.

step 3 of 9
step 4 of 9
And then I warped the pipes/wires to fit her shoulder. I did this a few times, but it's not too difficult and you should catch the changes.

- 5: source 5
step 5 of 9
step 6 of 9
I also used a metal texture and set the layer to multiply to create a nice metal/fabric look. (I know, I know.)

- 8: source 8
step 7 of 9
Very simple lasso tool and dodge and burn tools.

- 9: source 9
step 8 of 9
I simplified the skin with Topaz Labs, I rarely do this, but this manipulation called for extremely smooth skin to create an unearthly look.
I also erased the right eyebrow to create a rounder shape.

step 9 of 9
I cropped out the sky, added a texture overlay (soft light), merged the layers over a copy of the original.
Then, I rendered a lighting effect, set my eraser to a low opacity and flow and erased the darker sections of the foreground.

Final result



