This image was first noise reduced with Noise Ninja, resized down, cropped and sharpened with unsharp mask, and then duplicated two times. The first duplicate was refiltered with Noise Ninja with Smoothness and Strength at maximum settings.
I then selected the 2nd duplicate (top layer), clicked on the "Add Layer Mask" icon at the bottom of the layers palette and used a soft brush on the background to bring through the noise reduced background.
I then flattened the image and was surprised at how small the file was. Shouldn't have been...the more sharpening you use the larger your file is...I was blurring a lot of my image and thus reducing the size of the file.