how to save changes made in picture box

i am using picture box tool(visualbasic-6) for displaying images on a form and  i want to know how can i save the changes that  made for the image in the picture box in runtime .I am able to save the picture but i an not getting the changes made on the image in my saved file. I am using Visual basic6.

suppose if we took a man image with out nose i am lodint the image on to the picture box. when i run the file then i am adding the nose to the picture and saving it.but in my saved file i am not getting his nose but getting the old file with out nose only. i want his nose to be also save in the new file but i am not ablt to do. so how can i do that