I've seen comments blaming it on being vegan. She looked this way for a good bit, like in this picture with her ex-wife.
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She lost a lot of fat in her face, so her jaw and laugh lines are super prominent, and her head looks huge compared to her neck. I get the feeling she thinks it makes her look more masculine, but it just makes her look gaunt. I can't tell if she had anything done to her lips, but they look cracked and chapped to me, like she's dehydrated.
There's just no light in her eyes nowadays, which makes the effect overall more chilling.