It's just a case of placing pixels until you've achieved a likeness. I don't have any specific procedure.
That face is amazing, enlarged it looks like nothing on earth but at pixel size it's great...how do you do that!?!
You make some very valid points ptoing. I've updated the folds and modified the outline. Hopefully that's improved things.
I might make a proper scene for him later, but this was just a quickie to give myself a break from revision.
Very nicely done, love the folds (could be made a bit assymetric though).
Other than that I would give him a small background, if only some dirt ground and sky or something.
The grey you used in the outlines is almost the same as the default theme bg, and it looks really awful on that around the head area.
Looks great for its size.