McKean is a mixed-media artist - he's as likely to use torn photographs and real ivy (as in the original cover for Violent Cases) as he is sculpture, photography and xeroxography (as seen in many of the covers for the Sandman comic).If you specifically want to make an image like the one in the example you give, you might want to do some research into xeroxography and also into photographic techniques and into the use of transparancies. While he may end up with an image on paper, he works with image reproduction techniques to come up with a final "print" rather than merely cutting and pasting photographs together.If I were going to create an image like the one in your example without turning to digital manipulation, I would be looking to choose a main image - such as the large face in the example - to use as a a background. I would then transfer images onto transparent plastic, layering them to build up the image, taking care to experiment with contrast and transparency settings as I went. Assuming that the original image was also transferred onto a transparent film, colour could be added using art board and paints in the background - McKean used acrylic early in his career, so that seems like a good media to try.I find it hard to believe McKean doesn't use digital manipulation in his modern works. However, by looking back at some of his earlier works - his covers for the Sandman comics would seem ideal for this purpose - I believe that a good appreciation of his methods can be established. There are no easy answers here - it really is a matter of research and experimentation.You might want to try http://www.geocities.com/SoHo/Museum/8250/Dave.Mckean.html for examples of his work listed alongside the materials and methods used in their creation.