Finally, in Photoshop, I add textures, shadows and lighting effects along with the final text.
Then it's off to the printers, but the process doesn't end there. The printers usually have some technical stuff for us to change, so we have to go back and forth until everything is fit as a whistle, sharp as a thistle. Then we play the waiting game. When we get tired of the waiting game we play Hungry Hungry Hippos.