Allure has done an exhaustive retrospective on Michael Jackson's face with the help of Steven M. Hoefflin, his plastic surgeon through the 1980s and '90s, and his dermatologist/suspected sperm donor, Arnold Klein.
Here are a few of the reference points from his metamorphosis:
Jackson falls and breaks his nose. This gives him an opportunity to change the feature he has come to detest, thanks to merciless teasing. He will later tell Oprah Winfrey, "I'd hide my face in the dark." The results of Steven Hoefflin's surgery are visible on the Off the Wall album cover.
Jackson's skin tone here is much lighter, the result of skin-bleaching creams, pale makeup, or both. There is no sign of the blotchy pigment caused by vitiligo, but as a friend points out, "You'll notice that Michael often wore long sleeves and military high collars to hide his neck." What he can't cover with clothing and wigs, he covers with makeup. The tip of his nose seems narrower, more pointed, and upturned.
Jackson's gaunt look reflects a loss of fat in the face. Klein has said he was using injections of Restylane, a temporary tissue filler, to build up some areas and even out others. Previous steroid injections in the nose have likely made the skin there so thin that the tissue-filling gel injected by Klein seems visible underneath. One expert says the indentation on the side of his nose may be from a recent skin-cancer biopsy.