I think it needs a bit more contrast/clarity on the tattoo. Are you trying to make a feature of the tattoo or not?
The problem is that it competes with her face for your attention
On her cheek, is that a serious dimple or a pock mark, I'd probably run the "heal" brush over that to make the cheek smoother.
There's also a mark on her back level with her armpit that I would remove.
Also there's something about the angle her eyes are looking out at the camera, but that might be how her eyes are naturally.