I would imagine with enough concentration, if it was just a projection, then one could convincibly change their appearance, not speaking on size. I would imagine that the way someone looks is probably somewhat hard coded into the soul on a subconscious level. But there is probably a method to altering that so that you appear different than you are. Though that would create a whole host of new problem. Not to mentiont that it would be rough on the artist to be creating double the number of characters.
But I guess Ichigo's link to the living world could affect him. He can still go back to his body, so the chain of fate is still attached. Though didn't they like cut his chain of fate so that he could become a soul reaper again. So wouldn't that mean that he really is physically dead or departed from his body. I know that they removed him from his body and then cut the chain. And I guess he still puts himself in his body, as he would need something for people to see him still. It is a fuzzy area with that what happened during their training session before going to the Soul Society.
I am pretty sure that would make him dead and unable to return to his body the chain being broke. But Ichigo is unique in a lot of ways and while they do not have to explain things, it a littel sketchy. I mean Orihime was in danger of dying because her brother was beating up on her soul and chain if I remember. But her chain was still attached so she could return to her body.
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