I suppose the question here is whether Madonna had declared that, or whether others have declared it based on her actions, or whether you think celebrity status is a state of declaration.

These things are always up for debate, plastic surgery and other cosmetic surgeries aren’t going away any time soon - and it’s whether cosmetic enhancement becomes the norm. I suspect people may have felt a similar way to tattoos at some point… I think she looks fine, but I’m also faceblind and couldn’t pick her out of a crowd anyway. :o)