Fantastic. I really like the off center focus, your eyes go straight to her eyes. The ruffled shirt removes the natural soft lines that would be next and instead its a strong focus to the top left corner. Also there is something to be said for b/w photography. Less focus of makeup and the like and instead simply the subject.
Ah damn it, I was really loving her until you mentioned the Dr. Tatas bit. I'm not against boob jobs per se, I just hate it when a woman lies down and you get treated to a nice sex scar going round and up her tits.