As the first woman to dominate the male world of pop, Madonna, who now turns 65, already has a powerful cultural legacy to celebrate.

With more than 300 million records sold and a fortune estimated at $850 million (€775 million), Madonna is one of the most successful women in the music industry. She has topped Forbes magazine's yearly ranking of highest-paid women in music 11 times. She's earned 28 Grammy nominations and won the award seven times.

Beyond her work as a music star, she is also an entrepreneur, writer, director, producer and designer. And while her acting career may have struggled to take off, she still won a Golden Globe for her role as "Evita" in the 1997 movie version of the musical.

Breaking taboos

Madonna Louise Ciccone was born on August 16, 1958, in Bay City, Michigan. She had her big break in the early 80s, causing a sensation with her rebelliousness and bold sexuality.

She became synonymous with pushing boundaries and breaking taboos, fearless of creating controversy with songs like "Papa Don't Preach," about teenage pregnancy, or provocative music videos such as "Like a Prayer," which featured burning crosses and a Black Jesus.

Over the years, Madonna managed to inspire and surprise with her versatility and ability to reinvent herself in terms of music, style and identity.

Madonna in 1985 Deutsche Welle

The world has known her as a provocative rebel in torn fishnets and fingerless gloves, or as a sex bomb in Jean Paul Gaultier corsets; she then took an unexpected spiritual turn, exploring Kabbalah Jewish mysticism and adopting the Hebrew name of Esther in 2004.

She then embarked on her parenting journey and is now a mother of six — Lourdes, 26; Rocco, 22; David, 17; Mercy, 17; and twins Stelle and Estere, 10. She formed headline-making power couples through her two marriages, first with US actor Sean Penn (1985-1989), and then British director Guy Ritchie (2000-2008).

The entertainer who loves to provoke is the author of books as varied as Sex, a 1992 coffee table book featuring softcore pornography and depictions of sadomasochism, and The English Roses, a tale for children with a moralistic tone. It became the fastest-selling children's picture book of all time upon its publication in 2003, and she donated all proceeds to a children's charity.

Her philanthropic endeavors are also varied and well-known and include her own charitable organizations, the Ray of Light Foundation and Raising Malawi.

Another headline-grabbing coup: Madonna and Britney Spears kissing on stage at the MTV Music Awards in 2003 Deutsche Welle

Pushing the boundaries of age

But recently, it seems that most of the attention Madonna has been receiving surrounds her relationship with plastic surgery.

The pinnacle of the obsession came earlier this year at the 2023 Grammy Awards ceremony. Madonna introduced Sam Smith and German singer Kim Petras' performance with a speech about the power of rebellion. It was a historic event, as Petras is the first publicly transgender singer to win a Grammy. However, Madonna's unrecognizable cyborgian face stole the limelight and sparked a huge debate in the days that followed.

The media attempted to find out what the star had done to her face. According to Chicago plastic surgeon Michael Horn, beyond plastic surgery and a nose job, "she has seemingly used excessive filler over time, giving her face a full appearance and taking away from the natural and pleasing bone structure she once had," he told British tabloid Daily Mail. "What is most noticeable and striking is the drastic change in Madonna's facial shape into a more V-shaped structure."

Shortly afterward, the Queen of Pop laughed it off by tweeting a selfie with the caption, "Look how cute I am now that swelling from surgery has gone down. Lol."

Until then, she had never publicly addressed the issue, apart from being quoted in 2012 in the UK's Mirror as having said: "I am certainly not against plastic surgery; however, I am absolutely against having to discuss it."

But she also slammed the critical comments in an Instagram post: "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," she wrote.

"I have never apologized for any of the creative choices I have made nor the way that I look or dress, and I'm not going to start. I have been degraded by the media since the beginning of my career, but I understand that this is all a test, and I am happy to do the trailblazing so that all the women behind me can have an easier time in the years to come."

She concluded her post by stating that she was looking forward to many years of "subversive behavior," "crossing boundaries," and "standing up against patriarchy."

But is trying to stay youthful in an obsessive way really an empowering message for women? Many critics rather see it as playing along with what men, and society and general, expect of women, and of stars in particular.

But Madonna has never shied away from playing with those codes anyway.

Madonna wearing the iconic Jean Paul Gaultier cone bra corset on her 'Blonde Ambition' tour in 1990 Deutsche Welle

On the myth of 'aging gracefully'

In all cases, it is basically impossible to fulfill those expectations without letting it show at all.

As beauty reporter Jessica DeFino put it, people were upset by Madonna's new face because it was, "on some level, exposing the truth: that anti-aging is an inhuman goal, and attempting to anti-age — or 'age gracefully,' whatever you want to call it — actually takes an incredible amount of effort," she told Glamour magazine.

Similarly, TIME magazine's Belinda Luscombe argued in her piece "Madonna's Face and The Myth of Aging Gracefully" that the concept of "aging gracefully" is simply a myth: "One common criticism when women drink too deeply from the filler/Botox/surgery cocktail is that they should 'age gracefully,' a piece of advice that is about as useful as telling novice ice skaters to glide effortlessly."

"Nobody glides across ice, or ages, gracefully without a lot of effort, including input from skilled professionals. It's not as if older female celebrities who don't look as manufactured as Madonna are widely lauded. Nobody is heaping praise on more or less normal-looking women."

Health scares

Meanwhile, the Queen of Pop has been dealing with more burning issues. In late June, the star was hospitalized due to a serious bacterial infection.

The star had to postpone the North American leg of her world tour "Celebration," which pays homage to her more than four-decade-long career.

This is not the first health issue Madonna has had in recent years. In 2020 she underwent hip replacement surgery following an injury sustained on her "Madame X" tour.

But it seems the Queen of Pop has no plans to slow down. "My focus now is my health and getting stronger, and I assure you, I'll be back with you as soon as I can!" she wrote in an Instagram post following her health scare.

Her tour in Europe is set to start in October 2023 and includes four performances in Germany.