She has made her name by being one of the most controversial performers in the world but Lady Gaga may be taking the shock factor a bit far.
The singer just released this photograph of herself with a clearly altered appearance as part of the promotion for her new album, Born This Way, which is released on May 23.
In the photo Gaga is sporting prosthetic cheek bones and painted eyebrows which make her appear gaunt and emaciated.
Alien: Lady Gaga just released this picture via her Twitter account of her looking emaciated and gaunt
Shock jock: Lady Gaga, seen here last month in Paris, is known for her crazy costumes
The shocking photo was posted by the star on her Twitter page and is the first official posting regarding her highly anticipated new record.
Gaga's rail-thin frame has been the subject of much speculation since she rose to fame.
Last year the author of an unofficial biography, and ex-GaGa tour manager, David Ciemny, claimed the star was hospitalised six times in 2009 due to her starving herself to fit into her outrageous stage costumes.
Born This Way will come as her second major studio album.
The 24-year-old singer clearly goes to great lengths to provoke a reaction from her appearance and even admitted last week that her hair is now falling out from all the over-dying.
Gaga, who is naturally a brunette, has become known for her platinum blonde locks says she misses her dark hair when she 'has to get a chemical hair cut because my blonde hair is falling out,' she told People magazine.
While promoting the upcoming album, Gaga has also been busy continuing her Monster's Ball tour.
Tomorrow she will be performing in Oakland, California then Sacramento on Wednesday before heading to Las Vegas this weekend.
Fresh faced: The singer appeared healthier and more natural aged 18 when she was attending Manhattan Girls School
As well as continuing her tour, Gaga has been busy praying for those caught up in the troubles in Japan.
She has also been busy raising funds for the region, designing a prayer bracelet, the profits of which will go to a Tsunami relief fund.
In just 48 hours sales raised more than $250,000 for the charity.
