I am offended you assumed I didn't do it freehand with a paring knife.:0
I use V-Carve Pro and send the G-Code to Mach 3. V-Carve allows you to create g-code to machine 3d models from places like thingverse.com. It automatically sets up a tool chain for you. So, this was "roughed out" using a 1/4" end mill. Then the finishing detail was accomplished with an 1/8" ball nose end mill.
The 1/4" end mill was cutting at .125" depth and 30 inches per minute... I think I could have gone faster because this was just a pine panel, but I just finished modding my machine to make it more rigid, and am just dialing in my 600watt spindle so I took it slow. The ball nose bit then only had to make a single pass to carve out this level of detail. I don't think it had to go any deeper than .05", the software is that good. It's fascinating to watch.
V-Carve Pro is by far the best investment I've made (along with Mach3). The support, tutorials, newsletters, have really advanced my CNC capabilities. BUT I have not tried anything else so my opinion means little. I do know that it gives you unlimited control to adjust your depth of passes, create a tool and materials library, ramp your plunges, add tabs, do perfect V-Carving, import all manner of graphics... it does everything - EXCEPT - you cannot CREATE 3D models. You have to import them and then can manipulate them. You can create 2.5d models and projects, but you have to upgrade to Aspire for big dollars to design in 3d. The v-carving capability alone was worth the price in my opinion.