Has she had work done?
While Heidi Montag is a vacant starlet in the truest sense (see this), nonetheless her complete plastic surgery makeover is a bold move, and raises some interesting questions about, umm, the boundaries of identity. While I'm tempted to say that in becoming a completely different person, Montag is making a profound political statement, she's most likely playing out some kind of body dysmorphia to tragic effect. But whatever the motivation, her physical transformation is intense. She has actually become a different person, extracting the essence of transgender surgery to rebuild her face and body rather than tweak it.
Unfortunately her face is so bruised she's unable to promote her new album Superficial, suggesting her planning skills are somewhat underdeveloped. But seriously, ever since starlets caught wind of this Warhol(ian?) notion that even the most superficial fame has its own innate meaning, I'm really bad at picking the idiots from the canny ones.