You can place surfaces on the face of a character to make something like that. Some people, as ThatGuyBrian said, use item sheets and make the use of the 3D item feature to make 3D things such as ears, 3D swords, 3D hair, and some other things.
I have a passion for deca city conflict wallpapers for some reason, and here's another one i made.
By the way, the medkit is based on sketches i made for Deca City equipment.
For some reason with transparent objects (Leaves etc), when looking at the sky, transparent objects just completely ignore the light surrounding it.
actually for some reason this only happens with point lights, i guess spot lights are more sophisticated?