I am cinching the quilt around me. I have an EE Revelation 20° with overstuff. I have also taken my GoLite Ultra 20 into the high teens. Both times, the quilt was around me, not the pad.
Above freezing, I have used a wool beanie for my head; though, I would like to get or make something like the ZPacks Goose Hood to try as well. For that low with the GoLite (which has far less down than the EE Revelation) I wore my WM Flash jacket to bed. It helped me take the quilt lower and kept my head warm.
I just got the EE Revelation, so I've only had it out one night. I gave myself a few inches of shock cord for all but the last loop and slid into the bag. Then I snapped the top together and cinched the drawcord tight around my neck. The Revelation was too warm for me to wear the Flash to bed (I sleep warm), so I put just the hood of the jacket on and tucked the edges into the bag. That worked okay enough, but it won't be a long-term solution. I did start the night with just my usual wool beanie and some fleece ear warmers, and that wasn't enough (clearly). Thus the reason I'd like something along the lines of the goose hood for the long term.
I'm still not sure how low I can take my Revelation 20°, and I'm surprised how well quilts have worked for me at that temperature. I was initially skeptical and thought a true bag for 20° F and lower would be better. But I couldn't afford a WM or similar bag, and I had taken my GoLite pretty low with some success, so I gave it a shot.
Frankly, this is where time and experimentation come in. I am not totally sold on quilts below freezing, even though they have worked well for me. Being a larger guy (wide shoulders, broad chest, etc.), they are a lot lighter and easier to use for me than traditional mummy bags. But as I push my skills and gear deeper into the winter, that may have to change. I want to keep my kit relatively simple, and three or four bags feels excessive. Right now, this makes sense where I'm at. If further experimentation changes that, then I'll adjust. Part of learning something new is allowing for new knowledge and information as things progress.
While I am trying to avoid spending excessive amounts of money on what is--let's really be honest--a first-world hobby, I also don't want to have too many specialized or unused possessions. All that gear unused for most of the year weighs more than any used gear ever will.