This piece was used for the sister album to Six Feet Under's "Undead"..."Unborn". It was very clear that the two albums should be thought of as twins, but they didn't want to use the exact same cover. 

We decided that it was best to keep the skull at the bottom the exact same skull, but paint a completely new painting in a different palette that meshed well with the original. Again, I took to the lyrics and just went wild with swirls and details.

I think both album covers have a nice balance of similarity and difference. And I personally think that they speak volumes about what kind of music is contained inside.