The bigger flower of plumeria on the back represents ancestors (and so does the ipu symbol on it, as well as descent and fertility).
The sun around the ankle bone (eternity and joy) is made of shark teeth (strength, adaptability) with a turtle shell motif representing family and joining here the plumeria of her ancestors and the two smaller ones for her sons.
The shell is for love, intimacy and safe shelter, the koru is for new life and waves were added to symbolize the love of Michelle for the sea.
The seagull on top represents freedom and watching the world from a higher point of view.
The Marquesan cross joining the two smaller plumerias of her sons represents balance, union of the elements and harmony, which is what her sons are to Michelle.