It's taken a bit of time to get used to the software - I'm not the most photoshop literate - so I haven't made any full Silhouette cards until now. Yesterday I created a lily of the valley design (2 leaves, 3 stems and 16 flowers), cut them out and made a card. I also cut a frame for the inside birthday congratulations.
So, how does the Silhouette work? You create/open/download your design, resize it and lay out the pieces you want cut (pieces you want cut from other papers can be put off to the side of the cutting area).
Load your media (ie, put the paper onto the sticky carrier plastic and put it under the runners on the machine),
then send the design to the machine once you've specified your settings. In this picture you can see the green frame I'm cutting, while at the bottom, the center of the frame (in purple) won't be cut.
Cut your shapes, peel them off the backing and use. The knife will score into the backing sheet (you can see the frame in the plastic if you look closely), so be sure to use the correct one (along with the correct knife and cutting settings).
And here's the card I made:
And if you're curious about what it sounds/looks like when cutting, here's a short example: