Silent Hill 2's Pyramid Head design came to life from a painting in the game, not James's mind. This information came from a recent comment by art director Masahiro Ito.

Pyramid Head arrives as part of Dead by Daylight's upcoming Silent-Hill-themed DLC - which also includes a suitably sinister new map and familiar survivor - and marks the game's seventh licensed ...

So if I’m being honest, that’s one of the reasons I designed a creature with such a bizarre yet simply shaped head and a human silhouette. Masahiro Ito – Silent Hill 2 Concept Artist ...

Numskull's next Silent Hill statue is here, and it turns out the silhouette at the end of the Bubble Head nurse statue reveal did indeed tease the arrival of Silent Hill 3's protagonist, Heather.