The world watched Michael Jackson's appearance morph through the years, and there's been a lot of speculation about the surgeries he may have had. Now, we could have some answers.
And those answers are in a document that's played a key role in the case against Dr. Conrad Murray -- the autopsy report. Prosecutors have focused on the autopsy conclusion that Jackson’s death was a homicide due to propofol intoxication, but the report shows far more about Jackson than just his cause of death.
It details every scar, tattoo and mark on the singer's body.
We had plastic surgeon Dr. Thomas Romo analyze the autopsy report and tell us what he thinks. Dr. Romo is the Director of Facial Plastic and Reconstructive Surgery at Lenox Hill Hospital and the Manhattan Eye, Ear and Throat Hospital in New York City.
Here’s what he says the document reveals about the super-secretive star:
On Oct. 11, Dr. Christopher Rogers testified Jackson was “healthier than the average person of his age.” Despite photos shown in court of a deceased and seemingly gaunt Jackson, the medical examiner found the star healthy aside from minor ailments, like arthritis and the skin condition vitiligo.
The report says Jackson had a three-quarter-inch scarring behind each ear. Dr. Romo says those scars could have come from several different procedures.
“When incisions are made behind the ear it can usually be done because you’re pinning the ears back,” Romo said. “When one does a limited face-lift, you can also have limited incisions behind the ear.”
But, because Jackson’s scalp was severely burned during the filming of a Pepsi commercial in 1984, Romo said the scars could have also been from skin grafts used to cover the singer’s burns.
“Many times, when I do reconstructions of the face, I take skin from behind the ears because it’s camouflaged real well,” Romo said.
Jackson also had small scars on both of his nostrils, which Romo says can be a tell-tale sign of nose-narrowing procedures, like rhinoplasties, better known as nose jobs.
In the 2003 documentary, “Living with Michael Jackson,” the singer admitted having two rhinoplasties to improve his breathing, but he denied having any other plastic surgeries.
“Michael Jackson was an international, star performer,” Romo said. “The requirements for somebody like that, who’s looked at in a large arena, has to have a certain look.”
At the bottom of his neck, Jackson had two scars, both about three inches long. Dr. Romo says the scars could have been the result of a neck lift but could have also come from further skin grafts.
Romo said Jackson put demands on his body like any other athlete, and he had the scars to prove it. The pop star had several marks indicating surgeries on his right shoulder and knee. He also had one-eighth-inch scarring on both of his wrists, which Romo attributes to carpel tunnel surgery.
Jackson’s left arm also had a quarter-inch scar near the typical IV insertion point. Dr. Romo said this scarring could have come from functional bicep surgery, but he said similar scars occur after numerous IVs insertions.
On his right hand, Jackson had a nearly one inch scar running from his thumb to his wrist. Romo said there are a few explinations for this scar including trauma or it could be the result of a surgery to repair ligament damage.
While Jackson had multiple tattoos, they are not necessarily what one would expect for a rock star. The autopsy shows he had a “dark skin discoloration resembling a tattoo” on front of his head. Romo suggests the tattoo was to cover burned areas of the scalp, which may have never re-grown hair, and to combat balding, which the autopsy shows Jackson was experiencing.
“If you look at his current pictures, he’s got this very black horizontal hair line,” Romo said. “I’m sure a lot of that was tattooed in along with either wearing hair pieces and/or implantable hair pieces and/or hair plugs.”
The pop star also had dark tattoos on his eyebrows and eyelids, and a pink tattoo on his lips. Romo said tattoos like this are surprisingly common and offer patients a form of permanent makeup.
The autopsy shows several scars on Jackson’s stomach, including a two-inch scar on his lower right stomach area and small, circular scar around his belly button. Romo said there’s no mystery to the first stomach scar, which he attributes to an appendectomy. The other scar, however, holds a little more mystery.
Despite Jackson’s thin appearance, Romo said the location of the scar could indicate liposuction or a cosmetic surgery to tighten stomach muscles. But the surgeon doesn’t rule out the possibility of an operation to examine potential issues with his intestines, gallbladder, liver or spleen.
Here is a link to the entire autopsy report if you want to take a look. Warning: The autopsy contains graphic content.
If you want to read the part of the autopsy that focuses on Jackson's tattoos and scarring, click here.
_ In Session's Graham Winch and Cara Hutt, along with CNN's Kelly Byrom, contributed to this story. _