I just made one for my cousin's 50th. In the center, like a medallion, I put a pic of the Christmas photo he and his wife sent out. Next, I bordered this with a strip of their 3-year-old's handprints (coordinated with my cousin's wife). Around the outside, I used 12" blocks. The four corners were identical in framing the pictures. Then the final 12 blocks were each a different star block with the photo in the center. I used autumn colors which coordinated with the colors of paint used for the handprints. In the past, I made a photo quilt where each photo was the "window" in a paper-pieced schoolhouse block.