Very classy I really like the color scheme, The only negative I see is that the shrunken heads on the drums seem a bit too dark its hard to see what they are. which is really unfortunate because I really like the style of them. the bloody hand prints on the drum heads is a really nice touch. so is the skull bra. I think you could have made the cigarette in the cigarett holder slightly longer since it too gets lost a little and it took me a minute to figure out what it was she was holding. every thing else is great.
I agree that the shrunken heads are hard to read, I didn't see them at first! The cigarette/filter doesn't read too well. Almost looks like a paint brush. Perhaps if the filter was thinner and the cigarette longer?
My eye also wants the main portion of the image to be tilted counterclockwise, so the composition is more centered (but that might be more based on personal taste.)
The leaves in the background are pretty awesome, and the negative space with the white is nice, but perhaps the piece could use more of that to "pop" certain elements like the skulls and maybe more of the leaves.