As you can see I didn´t care much about her hand because they don´t be visible in final picture.
Step 4 - Changing Eyes
As you can see on the final picture the woman has blind eyes. You´ll do it in this step.
Add new layer on the top of your layers and name it BLIND EYES. Grab the Brush Tool (B) and select some small, soft, round brush. Pick some color similar to white of her eyes and paint over the irises. To get more realistic result change the color from time to time.
Step 5 - Adding Shadows arround the Eyes
In this step we will add shadows arround her eyes. Create new layer on the top of your layers and name it SHADOWS ARROUND EYES. Press B (= Brush Tool), pick some dark color, lower the opacity on about 40% and paint carefully arround her eyes. Bellow you can see how it should look:
Step 6 - Adding Branches
Download picture of branches and open it in Photoshop. Cut out the background. This may be little boring and time consuming but do it as carefully as possible because more precise you cut it out more realistic the result will be.
After you´re done drag the branches into your manipulation. Place the layer under the WOMAN and name it LEFT BRANCH. Press Command + T and rotate the brach in the same direction as you can see on final image. Bellow you can see what I mean:
Duplicate LEFT BRANCHES and name it RIGHT BRANCHES. Go to Edit > Transform > Flip Horizontal.
Press E (= Eraser Tool) and erase some branches from LEFT BRANCHES and then different branches from RIGHT BRANCHES. This will add variety and it won´t look like that you use only one stock image (and you don´t need to cut out two pictures of branches).
Bellow you can see how your image should look so far:
Step 7 - Blending Branches
Add layer mask to WOMAN. Grab the Brush Tool (B), select some soft round brush, lower the opacity on about 40% and pick black color. Now start painting over the areas of womans´ hands which should dissapear. Be very careful and work with low opacities and small sizes of brush to get natural result.
Step 8 - Adding the Roots
Download the picture of roots and cut out the background. Drag the roots into your photomanipulation, place the layer on the top of your layers and name it ROOTS.
Add new adjustment layer Color Balance and set it as shown:
Create clipping mask from this adjustment layer.
Now add adjustment layer Levels and set it as you can see bellow again. Create clipping mask from the layer.
Add the last adjustment layer to the roots - Hue/Saturation and set the value Saturation on -45. Press OK and don´t forget to create clipping mask.
Step 9 - Adding the Trunk
Download the photo of trunk, cut out the background and drag it into your manipulation. Place the layer on the top of your layers and name it TRUNK.
Add vector mask to TRUNK, press B (= Brush Tool), select soft round brush, pick black color and start blending TRUNK with WOMAN and ROOTS. Use smaller brush and lower opacity to be more precise and get more realistic result. Bellow you can see how the blending should look:
Step 10 - Adjustment of the Trunk
In this step we will fix colors and contrast of the trunk to fit the rest of the image.