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All my Asia-born friends who know of Ayu, but aren't fans say "Oh, she's that popstar with all the plastic surgery, right?". Even if Ayu hasn't had anything done, she apparently still looks like she has. Some of my friends claim that "it so obvious. She just looks like she's had surgery!".
imo, Ayu's face does often look different. Just look at all her magazine covers. I think, though, that its mostly just the tons of editing and photoshop they use on her face, plus makeup.
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