I only can speak from the limited experience with the one company. I don't know if they start from scratch, but they will personalize the whole body. My wife has a tattoo on her ankle and they even painted that in there. In the photos I sent she had a dress with a sweater and jewelry and they got all of that. I do believe that it may have been a stock body though with that just painted on there and maybe some clay added on to add for the weave in the sweater and the jewelry.
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