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

July 3, 2009 -- For all his towering influence as a recording artist, Michael Jackson lives in the popular consciousness not only as a huge talent but as a shadowy figure of intense self-conflict, a man who spent his career in flight from his audience, the world, himself.

"Man in the Mirror" was more than a hit song for Jackson. It was a reflection of a bizarre and enthralling series of identities, all of them written -- and rewritten, and rewritten -- on the star's face. The question of what drove Jackson to so radically alter his appearance gradually came to rival, if not overshadow, his brilliance as a performer.

"He didn't want to be Michael Joseph Jackson," said J. Randy Taraborrelli, who has followed Jackson's career for three decades and wrote an unauthorized biography. "He just wanted to be something else. And he went about the business of doing that."

Indeed, there are no shortage of theories from plastic surgery experts and biographers like Taraborrelli about the possible nature and number of surgeries behind Jackson's changing appearance -- and the reasons they believe the star did it.

In the 1970s, as the youngest member of the Jackson 5, Michael was the cherub-faced wunderkind no audience could resist. But even before he began to alter his features, Jackson was wearing a mask, concealing a feeling of unbearable pressure to succeed, brother Jackie Jackson said in a 1993 interview.

"I used to go to Michael's room and I see on his wall he's writing, 'I will sell 20 million records' on his mirror," Jackie Jackson said.

Margo Jefferson, a Pulitzer Prize-winning critic and the author of "On Michael Jackson," said, "I think he longed for some kind of peace of mind. ... He longed for what he could never possibly have back, which was some vision of a childhood. ... The little Michael Jackson, you know, who grew up struggling and suffering and ... thinking, 'I am worthless ... except when I can set this crowd going.' I think he wanted to flee that Michael Jackson completely."

Jackson's Changing Face: 'Staying Timeless'

It was after the unprecedented success of 1983's "Thriller" that Jackson's metamorphosis became far more than an artistic statement. In the video for the mega-hit, Jackson transforms from man to werewolf to man to zombie and back to man. It was as if he was using the story to preview the real-life drama of metamorphosis to come.

"I think he was obsessed with staying timeless, is what I think," Jefferson told ABC News' Cynthia McFadden in a recent interview. "It's as if he wanted to look like some, you know, being who has gone into some eternal realm of fame ... beyond life and death."

After the release of his fifth solo album, "Off the Wall" (1979), Jackson had an accident that would change him forever. He fell while dancing and broke his nose. It is believed that that's when he had his first plastic surgery.

In a 2002 interview with ABC News' Martin Bashir, Jackson denied that he had had plastic surgery beyond the nose job.

"I've had no plastic surgery on my face," Jackson said. "Just my nose. It helped me breathe better so I can hit higher notes."

Bashir was skeptical, asking if Jackson honestly was saying he'd only ever had one operation.

"Two," Jackson said. "As I can remember. ... Yeah. Just two."

Dr. Pamela Lipkin, a surgeon specializing in rhinoplasty, said it was unlikely the reshaped nose was better for singing.

"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."