2 tier, buttercream with fondant accents including toothbrush with missing bristles, magnifying glass, depends, "old age" pills & bottle, polygrip denture adhesive, comb with missing teeth. Word bubbles say "Karen's 50! Let's show her some support" (with purple bra below), "50 is the new 30", "50 comes with new skills... you can now laugh, cough, pee and sneeze, all at the same time!", and "When life seems like an uphill climb, take comfort in the fact that you're mooning everyone behind you!"