It's a mix! Most often we do some sort of analog sketch or model that leads to the final design. Recently, we talked about our process when we were guests on the Practice Disrupted Podcast and in our interview with Comicon.com. 😺 Here are the links if you are interested:

https://comicon.com/2024/09/17/qa-with-x-over-0-designers-of-the-uglies-geoheart-pendant/

https://practiceofarchitecture.com/2024/10/03/170-xover0-mixing-fashion-design-and-technology/