The last time I was in Build-a-Bear to actually watch a bear being made from start to finish was in 2001. I have only popped in there briefly since then. But the way it worked back then was that you would choose your animal skin/fur (back then it was mostly bears, but now there are all kinds of animals to pick - no pigs, though - my friend asked last year!), then you stuff it, close it up (you can put a heart or a voice chip in there too if you want it, I think), fluff the fur, give the bear a 'bath,' dress it in the outfits you choose (back in 2001, not as many Disney outfits or accessories; nowadays, they have a lot more), sit down at the computer and give your bear a name, get a birth certificate, have a ceremony (my friends had to put their hands over their hearts and swear to do something or another, and the employees - I forget what they call themselves - made them yell at the top of their lungs in the store, "I LOVE MY BEAR!!!!!"), and then they put the bear in the box with the little airholes and you buy it and off you go. It really is a cute process and fun for adults and kids alike. I am not sure if the whole process is the same now as it was in 2001, but I imagine it is similar.
She chose Tinkerbell. I got this picture emailed to me from the birthday girl's mom. It doesn't show the Tinkerbell outfit real well but you get the idea. It even came with a little green wand. 
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