 To be in the public eye as heavily as Madonna is, you're also frequently the subject of public scrutiny too. Considering she's been making hit music and turning heads since the late 70s, the superstar is no stranger to this, and regardless, has always stayed true to herself. However, at the 2023 Grammys, Madonna once again found herself on the tail end of controversy after viewers at home found the 64-year-old's physical looks almost totally unrecognizable. There's no question that Madonna has had cosmetic work over the years, but this time fans worried that the Queen of Pop has pushed things too far, and is now rocking a face overly full of physical enhancements. So, the question remains, what procedures could Madonna have had done? Many leading plastic surgeons are weighing in with their opinions from too much filler in Botox to multiple facelifts and other invasive methods, but the pop-ike on herself has never confirmed exactly what work she's had done or, if any, the most Madonna has spoke on the subject was back in 2012. When she stated in an interview, I am certainly not against plastic surgery, however, I am absolutely against having to discuss it. When it comes to plastic surgery, the golden rule should probably be less is more, but excess is more or less a modern-day celebrity's standard operating procedure. Some long-time beautiful celebrities like Madonna in this case are even becoming cautionary tales with experts weighing in to warn us that while some trendy procedures might start out looking subtle, they add up over time and can blow up in your face. Literally. And Madonna, while she's no plastic surgery virgin, even if she's never admitted to having work done in the first place. In fact, in a scene during her 1991 documentary called Truth or Dare, Madonna mocked the very idea of ever having plastic surgery when she promised that her entire body is the real thing. Nonetheless, there have been signs throughout her career that she's had a series of cosmetic enhancements over the years, and according to the MCAN Health Network's team of surgeons, Madonna's first surgery was likely a brow lift that happened sometime in her early 30s. Since then, it's believed that she's had a series of facelifts, with the first one probably taking place around the age of 37, and a second one having been performed some 10 years later in 2005. That being said, the first time we knew for sure that Madonna had work done was probably when her thesis was profiled on a 2008 New York magazine cover story entitled The New New Face. Come to think of it, that headlines a bit on the nose. At the time, Madonna had never admitted to having fillers done. In fact, she still hasn't, but still it's speculated. It wasn't until around 2012 that Madonna's tone regarding plastic surgery began to change in the public eye. That's when she spoke with the English media outlet The Mirror and told them, I am certainly not against plastic surgery, however, I am absolutely against having to discuss it. Despite her hesitation to openly discuss the topic, experts predict that Madonna has had somewhere in the neighborhood of 30 plus injections to her face over the last two decades and that her excessive use of the technique made it impossible for the look to dissolve, which on top of her earlier facelift procedures has resulted in an appearance with an overfilled upper face and a narrow lower face. Some would even suggest Madonna's new look went a step too far with Dr. Lawrence Reed telling the New York Post, It's unnatural, squarish and mannish. Instead of making it flush, they overfilled it. The chin to the jawbone should be a smooth transition. They added too much. This is a case of injections gone bad. What Dr. Reed is talking about is something called dermal fillers. They're made out of a natural compound known as hyaluronic acid, a substance that normally dissolves between six and 12 months. And it's what Madonna likely had injected into her face to give herself this appearance. Another popular option is to use your own body fat instead of a dermal filler. But taking excess fat from, say, your stomach and injecting it into your face can also lead to problems. After all, the fat in your stomach tends to gain weight faster than the fat in your face, which means that you could wind up with an uneven look as the excess fat that you injected expands quicker than the rest of your face. Well, regardless of which option you choose, the treatment is meant to smooth lines and boost volume. For the most part, these fillers have largely been used by women over 40 since 1981. But more recently, women in their 20s have been using them too. After all, we do live in the selfie generation. But here's the honest truth about face injections. If you go overboard, your cheeks puff up to pillow-like proportions and your lips could do the same. That's why it's called pillow face. And Madonna's not the only celebrity who has suffered from it. 13 years later, Madge would stun us all once again when she showed up to the 2021 MTV Video Music Awards looking like a whole different person in face and body. This time, an overly inflated face wasn't the only things fans noticed about Madonna's new look. They were also taken aback by the suddenly booing size of her chest. Now look, Madonna's never exactly been lacking in that particular part of her body, but those look new. However, it's hard to know if she's had a breast implant for sure. Now look, Madonna's never exactly been lacking in that part of her body, but those look new. However, it's hard to tell if she's had breast implants. What's easier to determine is that she most definitely had butt implants or a BBL, a Brazilian butt lift, as her rear end increased in size around 2019. Most recently at the 2023 Grammy Awards, Madonna's face was the subject of attention as well as some shock and backlash. While she's always had a famous face, this time viewers at home rendered the 64-year-old's new look almost unrecognizable. While presenting before other hot artists who are pushing boundaries like Madonna herself has always done, such as Sam Smith and Kim Petras, who performed unholy, fans still felt the need to express shock from Madonna's appearance. I mean, it is somewhat shocking, but if you've been following her TikTok for instance, then I mean, you've definitely seen how Madonna's been looking recently. Regardless, comments began to roll in from devoted fans to vicious news anchors, attacking the way Madonna looked. The folks over at Fox News suggested climate activists might be seconds away from coming after the singer for quote-unquote all the plastic in her face. Some rude commenters even stated that she had a striking resemblance to a 2,700-year-old vampire who eats babies and small animals alive. I don't even know what that means, but okay. Fans mourned the loss of Madonna's old face, wishing she never would have dabbled with so much cosmetic work in the first place. It's quite clear Madonna has had a facelift or a couple, some eyebrow lifts, lip injections, filler, perhaps buccal fat removal and likely more. None of this can be confirmed by anyone other than the pops are herself or her doctor, but most of those noticeable nip tucks begin to seriously take shape around the time Madonna was reaching her 60s. The 60s are a notorious point in a person's life when the skin begins to wrinkle and sag, so I guess that makes sense. Dr. Michael Horne, a Chicago-based plastic surgeon, gave his professional opinion after the Grammys about Madonna's latest looks, and he believes the material girl likely went under the knife recently. He said, last night's appearance at the Grammys showed the most different-looking version of Madonna we have seen. She has undergone a facelift. This is obvious because her skin is tight and pulled back with no wrinkles. Her eyes also seem smaller, likely due to being pulled during a facelift. Madonna previously had a natural nose that suited her face. It appears as if she's had rhinoplasty since this version has a pointy tip and seems to narrow. Dr. Horne added that Botox was evident on many parts of her face since there was a lack of expression lines and wrinkles, as well as minimal facial movement when she gave her speech. At the end of the day, Madonna's face and body is hers and hers alone, and she can do whatever she wants to it. The truth is no one can or should have the right to tell her or any celebrity how to live their life or what cosmetic work they should or shouldn't do. And Madonna, well, she also agrees. After she began to get criticized for her appearance at the Grammys, she took to social media to clap back. Madonna explained that she was excited to present Sam Smith and Kim Petras before their history-making performance for Unholy, but rather people decided to focus more on her looks. She said, instead of focusing on what I said in my speech, which was about giving thanks for the fearlessness of artists like Sam and Kim, many people chose to only talk about close-up photos of me taken with a long lens camera by a press photographer that would distort anyone's face. Madonna continued to say, once again, I am caught in the glare of ageism and misogyny that permeates the world we live in, a world that refuses to celebrate women past the age of 45 and feels the need to punish her if she continues to be strong-willed, hard-working and adventurous. I mean, she's not wrong. She also added she never apologized for any of her creative choices or the way she looks and won't start now. Madonna hopes to continue being a trailblazer in the industry so that women after her may have a quote-unquote easier time. Finally, she said that she looks forward to many more years of her iconic behavior and pushing boundaries, standing up to the patriarchy and most of all enjoying my life. So one thing is clear, regardless of the work Madonna has or hasn't had done, she couldn't care less what people have to say and she's too busy living her life. Not to mention the Queen of Pop will be hitting the road between July and December 2023 for her 40th anniversary tour. So if any of us are lucky enough, we can maybe get to see Madonna's face live as well as her amazing show. But for now, folks, that will conclude today's before and after. Before we go, answer me this. Do you think the public in Hollywood are far too harsh on women in the natural aging process in comparison to male celebrities too? Let me know your thoughts in the comments below as well as how we might be able to change that narrative. If you'd like to check out some more episodes before you leave them, be sure to look up our other before and afters on other icons like Priscilla Presley. My name is Cara the Vampire Slayer. Follow me on Instagram to chat more and I'll see you all in another one. Bye.