Why Did Michael Jackson Go So Far to Alter His Appearance?

"Which nose do you think would breathe better?" Lipkin said. "A normal nose ... that has normal structures, all of which are designed to help breathe? Or something ... that's totally devoid of any natural structure?"

As the makeovers became more extreme, the public seemed to become ever more fascinated. Jackson even seemed to tease his fans about the color of his skin in the music video "Black or White." But the lyrics were no confirmation he was changing his skin color, according to Jackson, who told Oprah Winfrey in 1993 that the changing color of his skin was the result of a disease called vitiligo.

"I have a skin disorder that destroys the pigmentation of the skin," Jackson told Winfrey. "It's something that I cannot help, OK? But when people make up stories that I don't want to be who I am, it hurts me."

Lipkin characterized the explanation as dubious.

Jackson's Changing Face: 'The Honest Truth'

"It's the most unusual case of vitiligo I've ever seen," she said. "I think he's bleached his skin, possibly to blend in what might have been vitiligo. But I have to wonder what came first, the vitiligo or the desire for lighter skin. ... It's obvious that he's trying to look Caucasian. His skin is whiter, his nose is getting thinner every six months. His lips are getting thinner."

But Jackson told Bashir that just wasn't so.

"I'm telling you the honest truth," the star said. "I don't do anything to my face. ... Honestly."

Dr. Steven Haughlin performed plastic surgery on Jackson until the late 1990s. Ten years ago, he told "20/20" he only did what Jackson asked him to do.

"I think he wanted a feature that bothered him to be made smaller, more sculptured," Haughlin said. "He's very happy with what he's done, OK? I think he's done more than I recommended in terms of the changes, yes."

Lipkin said she wouldn't perform such surgeries, but declined to criticize others who would.

"You've got to give the surgeon a little credit," Lipkin said. "He fulfilled Michael Jackson's wishes. He was able to recreate a face, change it drastically to make him, possibly, happy. I do believe that this is what he wanted to look like."

Lipkin said that Jackson had become addicted to plastic surgery. "Addicted, addicted to plastic surgery doesn't mean you've had 10 operations or 12," she said. "It means that no matter how much surgery you have, you're still not happy with the way you look. He kept focusing on his nose. It became, his nose became the obsession."

An obsession that led to further surgeries, leaving Jackson with barely a nose at all.

"What I think has happened recently is that something in his nose, a graft, an implant, something has now come out through the skin," Lipkin said. "And that's why he's probably got a hole in his skin. ... They're called nasal cripples. People whose nose has been done so many times that there is no nose really to breathe through. Michael Jackson has what we call an end-stage nose, a crucified nose, one that's beyond the point of no return."

In his final years, the King of Pop's appearance continued to transform, his behavior as puzzling as the changes to his face.

"You know, we do know that he wanted in some way to be the greatest entertainer in the world, maybe the most compelling figure in the world," Jefferson said. "That's what so much of the life was about, constructing what you cannot ... rebuilding what you cannot possibly rebuild, which is a past that you are happy with."

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