My initial reaction (in terms of diagnosing why she did what she did) was basically the same as yours. However, there is another intriguing possibility. Perhaps the surgery wasn’t an attempt to conform to ageist and sexist beauty standards that just happened to backfire. Maybe the grotesqueness was the point.

Maybe Madonna’s no fool, and her whole idea was to shine a light on how ageism and sexism, if left unchecked, push us to absurdity.