Nov. 22, 2010 -- She was once reality TV royalty as a beloved star of MTV's "The Hills," but now Heidi Montag is probably more well-known as the queen of plastic surgery.
"I want to be happy," the 24-year-old said. "I've always heard you can't change the world until you change yourself and who you are."
Montag's shocking transformation after going under the knife for a marathon of at least 10 plastic surgery procedures in a single day last year has turned her from Hollywood starlet to tabloid target.
In a recent interview with ABC News' Cynthia McFadden, Montag said she feels like she's a prisoner in her own made-over body -- a complete backtrack from the "no regrets" position she had in an interview with ABC News' Juju Chang earlier this year.
In 2005, Montag was a fresh-faced 19-year-old from the mountains of Colorado before she was cast on "The Hills." Even before she became obsessed with her looks and posed to remodel her face, Montag was already the center of tabloid white noise and gossip. That kind of attention was new to her.
"It really got to me what people would say about me, and saying I had a horse face, and a Jay Leno chin," she said, "just awful, really mean things about me. ... I kind of started believing it."
Her sudden fame and the pressure of trying to compete with the other girls on "The Hills" helped push Montag to believe that radical re-invention was the only way to go.
"I got really insecure once I got immersed into Hollywood. A lot of girls my age get almost as much surgery, I would say, as me. ... All these celebrities have different faces. Nobody calls them out because they don't talk about it," Montag said, adding that talking publicly about her surgeries was a mistake.
"I shouldn't have talked about it because it just opens it up for everyone," she said.
A big topic of discussion has been Montag's breasts. In 2007, a semi-clad Montag posed for Playboy. It turned out to be a pivotal moment in her transformation.
"That was before my surgery. ... They digitally enhanced my breasts," she said. "That was one of the biggest insecurities I had -- that all these people in a room were telling me, 'No, your breasts aren't big enough."
Montag then became more determined than ever to look Playmate-ready.
Heidi Montag Had Her First Implant Surgery in 2007
Later that year, she made a few subtle, yet visible, changes to her appearance. Montag had lip injections, a nose job and her first breast augmentation. Fascinated with the idea of a perfect Heidi, she went to see celebrity plastic surgeon, the late Dr. Frank Ryan.
"I went in there, and I talked to myself: 'What else could we do? If you had your dream person, what would you do to make me perfect?'" she said, referring to her meeting with Ryan. "We went through all the list, mini eyebrow lift, and my ears pinned back, and we went through it. I decided I wanted to do all the procedures."
During the nearly 10-hour-long surgery, Montag said she had her chin shaved down, her brow lifted, her ears pinned back, fat injected into her cheekbones, liposuction on her outer and inner thighs, her back scooped out and her breasts enlarged for a second time -- to a G-cup.
When she woke up in recovery, Montag said she was in excruciating pain.
"I thought that first night that I came out of the hospital, I was gonna die out of pain," she said. "I didn't think I could physically endure that much pain. I mean, I looked like I was hit by a truck. My body went through so much trauma ... little precision cuts, you know, throughout my entire body."
Montag described an ugly recovery period, during which the simplest of tasks were virtually impossible.
"I couldn't even go to the bathroom," she said. "I couldn't even walk for days. My face was so swollen. You know, my ear, everything had stitches on it. My back was black and blue.
"No one should look like that," she said. "You should only look like that if an accident happened and you're fighting to survive."
Montag Slams Her Late Surgeon
Not expecting to be in such horrible pain, or to look like she had been "hit by a truck," Montag said she was shocked at the toll the procedures had taken on her body. She claimed Ryan had made it all sound easy and didn't properly inform her of the painful outcome.
"I do not feel like I was prepared enough for this," she said. "Maybe I should have known. But how can you know when your doctor's saying, 'It's just a little of this, it's just a little of that'? You know, it really becomes a lot."
"I definitely think I should have been way more informed," she added. "I think that doctors should really walk you through all aspects of it, not just the glamorous side of it. Doctors, it's like they're selling you cookies or something."
Ryan died at age 50 earlier this year in a one-car accident when he drove off the Pacific Coast Highway in Los Angeles, reportedly after posting a tweet while driving.
Montag said that among the things that he failed to warn her about was that getting her ears pinned back would be an agonizing procedure.
"If I would have known that, I would have never done that," she said. "They pretty much cut your ear off and re-sew it on. ... They cut the whole back off and then re-pin it, and then they cut off some of my earlobe."
The difficult recovery also put a strain on Montag's new marriage to husband and "Hills" co-star, Spencer Pratt.
"He didn't sign up to be the nurse to his 23-year-old wife at the time, day and night," she said, describing how she was obsessed with how her healing was going and how she would constantly ask him if she looked okay.
"It was so traumatizing what my body looked like. I couldn't look in the mirror. I was hysterically crying ... and he's like, 'I didn't marry this girl.'"
The couple filed for divorce in July 2009 after just 15 months of marriage, although the divorce case was withdrawn in October. The two reportedly renewed their vows at a small ceremony in California last week.
Montag: 'I Almost Risked Everything'
Pratt wasn't the only person in Montag's life to struggle with her transformed self. In the sixth and final season of "The Hills," Montag revealed her new face and new body to her shocked mother, Darlene Egelhoff, as the cameras rolled.
"I'm sorry, it's very weird and very awkward...It sounds to me like you want to look like Barbie," Egelhoff told her daughter during the show's taping. Montag quickly replied that she did want to look like Barbie.
Montag told ABC News that off-camera, her mother apologized and said she wouldn't have reacted the way she had if they weren't being filmed, which made Montag so furious, she said she still isn't speaking to her mother.
Nonetheless, Montag has changed her view on how she feels about all her cosmetic procedures, adding that even the daily maintenance is a chore. She said upkeep involves massaging her face, and particularly her breasts, everyday.
"I don't want the biggest boobs in the world and, to be honest, I would take them out and downsize them but I don't want to go under the knife again," she said. "I feel like I'm stuck with them now. ... sometimes I wish I could go back to the original Heidi."
After the painful transition to this latest version of Heidi Montag, the reality TV star now admits she was addicted to plastic surgery and believes that the grueling procedures and recovery weren't worth the outcome.
Montag added that she thinks plastic surgery is scary and dangerous, and is adamant that none of her cosmetic procedures were worth risking her life. She now said she is done with wanting a bombshell image, and would prefer to be known for who she said she really is: a country girl at heart, living a simple life.
"I don't want to do that to my body again. I don't want to get any more Botox or any more surgery, or any more lip injections. I think I'm fine the way I am," Montag said, offering a message of caution to others who are considering going under the knife.
"I hope that people really hear what I'm saying about plastic surgery, and I hope they really hear that I'm saying I would take it back," she said. "I almost risked everything, all my relationships and myself, for vanity."