Customer service was able to explain the process before I placed the order. Once I placed the order, I was put in touch with a vendor who took details for the doll and provided me a 3d model. I made some adjustments to the model to get it exactly as I wanted it and the vendor was happy to make these adjustments. Once the final doll was printed, the painting done on it was pretty good.
Overall, the doll looks about 90% like the pic (minor variations because there's a lot of manual work to adjust the 3d model/drawing). The vendor was happy to make multiple rounds of adjustments. Slightly expensive for the quality of work, but the recipient of the doll really loved it. So, I would definitely recommend this doll if the cost doesn't pinch you