I've been wanting to improve this picture for some time, but have never been able to fix the noise in the background of these old pictures. I used the camera raw filter to smooth the background which also dramatically improved my grandmother's skin. The image had some dust on it which I repaired using the spot healing brush tool. My grandmother originally colorized this photo using some kind of photo pens or markers. I didn't want to mess too much with her old school colorization, but I did want to clear up areas where I could tell her markers bled. For example, she made the area around her lip look like she was having a bad makeup day, so I eliminated the extra color and redefined the edges of her lips. Finally, the entire image felt very flat, so I added a curves mask layer which dramatically improved the dark and lights of the image.