IMHO, for some purposes (eg, a flattering portrait for his family on the occasion of his death), the changes you made would likely be very much appreciated, whereas for other purposes (eg, any sort of news or photo-journalism), the changes would get your image tossed immediately into the rubbish bin because they are not true to the original scene, and, perhaps, more to the point, they erased evidence of the hard life, deprived of basic medical/dental services, the man has experienced.
Finally, for yet other purposes (eg, demonstrating your technical photoshop chops for a class, for your peers, or for advertising) the changes would essentially be a big yawn, i.e., "yup, this guy knows how to do moderately complicated things in PS", maybe the compositing department of the National Enquirer could use him.
The bottom line is that without knowing the goal of a manipulation, it's almost impossible to give truly meaningful feedback - i.e., whether or not you achieved your goal for the image.
Sorry I can't be more definitive.
Tom M