I love this piece. What puzzles me is the object in her chin, I believed it to be a needle, like how some people try to bring us down and stop us from being unique individuals, but she/he still lets their creativity out through the smoke. And to build off the idea of SapphireLights9, I would've been even more impressed if perhaps tears of black ink were to be coming from the eyes and flowing (with the blood) down her neck and into the tattoos/artwork on her body.
Overall, amazing. But to add some constructive critisism, I would go over the hair with black charcoal or soft oil pastel just to smooth out the hair a tad more. I just was a bit distracted by the contrast of the smooth skin and first strands of hair on the face, then suddenly big streaks of marker. Just my opinion, though.
Good Work =)