Michael Jackson rebuilt his nose before his death because extensive plastic surgery had left him with breathing problems, his doctor has disclosed.

Arnold Klein, Jackson’s dermatologist, said that he stopped him from going to a plastic surgeon and began rebuilding his nose and cheeks using fillers last year.

“I thought he had a nice-looking nose... but it got to the point where it was far too thin. It didn’t look natural to me,” Dr Klein told the CNN programme Larry King Live.

“I rebuilt it, using fillers. He was beginning to look like the nose was normal again. And that’s all I wanted — and to regain the breathing passages of his nose, because there was a total collapse of the cartilage.”

Dr Klein had completed work on the singer’s nose but was continuing to treat him for severe acne and scarring from plastic surgery before his planned series of concerts in London. He saw Jackson for the last time just three days before his death.

“I just was trying to get him ready to do the concert, because in the way he looked in his face he wanted it to be absolutely as perfect as it could be,” he said.

Dr Klein first met Jackson almost 25 years ago when he diagnosed the auto-immune disorder lupus. He said that Jackson also suffered from vitiligo, an auto-immune disorder that affects the pigmentation of the skin, and that he was not lightening his complexion to try to appear white.

“Michael was black. He was very proud of his black heritage. He changed the world for black people,” he said.

Dr Klein said that the skin condition gave Jackson a “totally speckled look” all over his body, particularly on his face and hands.

“We basically used creams that would even out the same colour and we destroyed the remaining pigment cells.” he said. “He had blotches but we evened out almost all of them.”

Jackson had to be extremely careful with sun exposure and began to shade himself under an umbrella, he said, but Jackson’s face-mask was just a “gimmick”. Dr Klein also revealed that Jackson had “lost a great deal of hair” as a result of it catching fire during filming for a Pepsi advertisement in 1984 and the ensuing scalp treatments.

In an effort to cut out the scar, Jackson’s doctors used tissue expanders under his scalp.

“Because he had lupus, what happened is that every time they would do it, the bald spot would keep enlarging,’ Dr Klein said. “So he went through a lot of painful procedures with these tissue expanders until I put a stop to it. He had to wear a hat all the time and it was really painful for him.”

Dr Klein also raised new questions about the paternity of Jackson’s two children with his former wife Debbie Rowe, a nurse who once worked in Dr Klein’s office. The dermatologist said that he believed Jackson and Ms Rowe had sex, and that Jackson could have been the father.

Dr Klein refused to categorically rule out the possibility that he was the children’s father, though, saying that he had once donated sperm to a sperm bank. “To the best of my knowledge, I’m not the father,” he said. “I want to tell you that this discussion, however, is between Michael, his children and this person. It’s not to be discussed who the father is over national television.”

He said that on learning of Jackson’s death, he immediately called Ms Rowe and told her: “I want you to get active and be the mother.”

“My greatest concern was what was going to happen to the children,” he said. “I told her that I didn’t want to see in three years the children doing the next version of the Jackson 3.”

Dr Klein denied that he had prescribed the star any drugs that could have killed him. “If you took all the pills I had given him in the last year at once, it wouldn’t do anything to you,” he said.

He revealed, however, that Jackson had once gone to a “secure setting” in Britain for treatment for drug addiction, “where he went off drugs altogether”.

Jackson’s body has reportedly been returned to one of the locations run by the Forest Lawn Memorial Park in Hollywood, awaiting burial. Dorothy Gaspar, who designed gloves for the planned “This Is It” tour, told the celebrity website TMZ.com that Jackson would be buried wearing a single white leather glove covered with Swarovski crystals, which was made for him about a decade ago.

Explore Music

• CD Reviews

• Live Reviews

• Classical

Editor's choice

• The 100 Best Films of the Decade
• 70 facts you didn't know about Marvel
• The 50 Biggest Movies Of 2010