Using the preset shapes again with the same settings as before I made a muzzle above the head layer.

Converted that to a raster layer, used retouch to add some shading and the same eyecandy jiggle.

Switching back to freehand draw with the same settings as before I changed my fill color to #B64040 and started making a bow under the head layer.

Converted that to a raster layer and used retouch for shading. I changed the size of both Lighten & Darken RGB to 10.

Above this layer, I used freehand draw to make more of the bow.

Converted to a raster layer and used retouch tool for more shading. Then used a drop shadow with these settings.

Using freehand draw again, I made the rest of the bow above this layer.

Converted that to a raster layer, used retouch to add more shading, and used the same drop shadow.

Use freehand draw or preset shapes and give this bear a face above all these layers.

Using preset shapes again with the heart shape and changing my fill color to #B64040 I made the first balloon.

Convert that to a raster layer and use a cutout with the setting below.

And then Lighten RGB with these settings...

To add two small highlights on the balloon.

Using the same settings for preset shapes and changing my fill to #F6F8FA I made another balloon above that layer.

Converted that to a raster layer, used the same cutout and lighten rgb to add the same highlights.

And then another balloon above that using a fill color of #406CB6...

Convert to a raster layer, use the same cutout and add the same highlight.

Then using freehand draw again with a fill of #406CB6 I made one ribbon on the balloon.

Converted to a raster layer and used Lighten RGB with the same settings as above to add some highlights.

And repeated this for the other two ribbons...

I then used freehand draw to make 3 little bows on the balloons above that layer.

I used an inner bevel with these settings on those 3 little bows.

And you are finished!