cut pages and reattach different shaped pages.this looks like what they now call a "Smash Book" used to be called a scrap book.but now scrapbooks are a whole different beast.which is why it's called a "Smash Book"
I will get one this year! These handmade altered-book journals are gorgeous. Such a talented artist! Click through to see the inside pages--they are worth it. (Love the tabs . although I don't think I could "deface" such an old school book .