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Madonna has sparked facelift rumours after she was spotted leaving a medical centre with two black eyes.
The 49-year-old singer masked her eyes with oversized black sunglasses as she left the New York building but the dark purple bruising was still visible.
Cosmetic operations on the eyes or nose can leave the patient with bruises.
Although Madonna has always denied going under the knife, insisting her youthful looks are natural, it is not the first time she has been dogged by surgery rumours.
In September, she was photographed with a new scar and swelling around her ear.
Celebrity plastic surgeon Alex Karidis said at the time: "I believe she has undergone a form of facelift."
In 2004, Madonna - who is 10 years older than husband Guy Ritchie - was at the centre of another surgery riddle.
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