Now the debate has reached its peak of intensity after the 49-year-old was named the ultimate face by a respected American magazine.
The magazine has hailed Madonna's facial features for her 'Mount Rushmore cheekbones, the angular jawline, the smoothed forehead, the plumped skin and the heart-like shape of the face.'
While her spokesperson will neither confirm or deny rumours the star has been cosmetically enhanced, her estranged brother Christopher Ciccone is adamant her dewy complexion is not natural.
Appearing on U.S. chat show Chelsea Lately last month, Ciccone was blunt about his opinion of his sister's famous features.
When told by host Chelsea Handler that Madonna would disapprove of her photo on the front of his book Life With My Sister Madonna, Ciccone said: 'Well they probably shouldn't have pulled it quite so tight...'
After being thanked by Handler for putting the 'face lift rumours out there,' Ciccone replied: 'Come on, it's there, nobody will say it. I will.'
Writer Jonathan Van Meter interviews Madonna's long-term publicist Liz Rosenberg, who also represents Cher, Michael Buble and Josh Groban, for her views on surgery.
Rosenberg insists she doesn't know whether or not Madonna has undergone surgery, but declares the singer looks 'amazing'.
She said: 'Whatever Madonna has had done - and I really don't know - she looks truly amazing.
'I have never represented anyone who has spoken to me about plastic surgery. Nor have I asked them. I don't want to know.
'But Anyone who has had it done, I'm all for it. These people, they are commodities, and improving on your product is the business they're in.
'Getting any artist besides Joan Rivers and Kathy Griffin to go on record about the subject is not easy. Of course one of the great quotes came from my gal Cher, who said in an interview, "If I want to put my tits on my back it's my business."'
Madonna is described as the embodiment of the 'New New Face', for having facial features highly sought after by cosmetic surgery customers.
According to claims in the New York feature, other celebrities lucky enough to have the sought-after 'New New Face' include Demi Moore, Michelle Pfeiffer, Elizabeth Hurley, Naomi Campbell, Stephanie Seymour and Mary-Kate and Ashley Olsen.
New York magazine sells the article as 'Madonna has it, Demi has it, even the Olsens have it. And it could be yours for about $30,000'.
Leading cosmetic surgeon Dr David Rosenberg (no relation to Liz Rosenberg) compliments Madonna's facial features in the article, saying: ' You see the architecture of the jawline, you see the architecture of the cheekbones.'
The demand for the 'New New Face' is eclipsing the formerly popular 'Old New Face', features that inspired plastic surgery in the 1980s and 1990s.
Hailing Meg Ryan as an example of the 'Old New Face', Dr Rosenberg said: 'Meg may think she looks beautiful, but what we are picking up on is a sense that maybe there is an over-inflation of the lips, there’s an over-abundance of fillers in her face.
'What I see with Demi is more of an operation. Let me say it this way: I see preservation of definition, a preservation of facial architecture. Angularity. Very pretty.'
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