So I'm still building out the mesh and extruding it along the frame of the head. I've found the sculpt geometry to be especially useful in terms of keeping the mesh in a nice form. Here's the current status:
Currently its approx 3000 faces, the back of the head and side/ear are not complete neither is the neck. I have half the face special duplicated over as an instance so I could get a better look.
Let me know what you think or suggestions on tools, I mainly use the extrude, soft select (which I discovered this morning by accident) and the sculpt geometry tools.