I started up in Lightwave Modeler by making the eyes, mouth and nose separately, polygon by polygon to form a flat kinda looking face. I then connected them togheter and subpatched the result for smoother surface.

I then added added the grass from the Grass source image as a simple texture. I then added some light to make the facial characteristic be more visible and make it match the source better.

The result was the face and a alpha mask.

...I then added the rendered model to the the Grass source image and erased with different brushes to make it blend in on the grass.

For the inhaling effect i played around with mixing blue/red clouds with differential clouds. I also changed the contrast and added some transparent duplicate layers with traced contours.

I then transformed the completed texture to cone down to the mouth. I also feathered away some of the edges and erased some random spots to make it more "cloudy".

The finished result was then added to the image somewhat transparent and matching layer effect (Don't know how to translate it).

The rest was more of a basic photoshop makeover. I changed the color of the sky to something more exciting than the original. I also made the grass look somewhat more dying to match the overall feeling.

As the layers had been put together i used the smudge tool to distort the background for a inhaling effect (or maybe exhaling?).

Cloudy shadows was then added to the ground. The face was shaded and the center of the inhale/mouth and the eye got itself some free handed glow.

After that there was just some general basic fine tuning.