The speaker in this poem uses tissue paper as an extended metaphor for life. She considers how paper can 'alter things' and refers to the soft thin paper of religious books, in particular the Qur'an. There are also real life references to other lasting uses we have for paper in our lives such as maps, receipts and architect drawings. Each of these items is connected to important aspects of life: journeys, money and home. These examples demonstrate how important but also how fragile paper is.
In the final stages of the poem, the poet links the idea of a building being made from paper to human skin, using the words 'living tissue' and then 'your skin'. This is quite a complex idea, and the meaning is open to interpretation. She may be suggesting that the significance of human life will outlast the records we make of it on paper or in buildings. There is also a sense of the fragility of human life, and the fact that not everything can last.