By 1981, Michael felt as though his life was out of control. The persona shown an stage is nothing like the man that lived offstage. The person he saw in the mirror was someone he did not like very much, controlled by others, and who's opinion did not matter much,but respected as an artist. He decided to concentrate on his appearance. That, he could control.
During a dance routine in 1979, Michael tripped and fell onstage, and when he hit the floor, he broke his nose. He flew back to Los Angeles and had his first rhinoplasty surgery in the spring of 1979.
The nose that we see on the cover of Michael's "Off The Wall" album, is the result. It is just a little smaller than the nose he was born with, but Michael liked it.
The doctor who performed the procedure did not do it correctly, which resulted in breathing problems, so Dr. Steven Hoeflin did the corrective surgery, and all of the surgeries done in the future.
Michael had severe problems with acne, and found through research that the type of foods that he liked to eat, mostly greasy, possibly contributed to his complexion problems. Following the lead of Jermaine, who solved his problems by becoming an vegetarian, Michael became one also. Not that he had a weight problem, but he longed for a dancer's body.
As a result of the change of diet, Michael's appearance became more streamlined, less round.His acne cleared up, and his more defined face was because of the weight loss from his vegetarian diet, not because of plastic surgery. Also, Michael was not a little boy anymore, he had matured into a young man.