Now, firstly I don't think the picture should have been put out at all , and I don't think she should have made that trip in a car without blackend windows. We were told she was having surgery and would be back after Easter and that should have been that.
For some reason they decided to put out the Mother's Day picture and manipulated it. Consensus appears to be that this was more than a minor tweak or two to make sure DC were all smiling at once or that the pimple on her nose wasn't visible. There's been significant work done, around her face.
For me, the interesting story is the way the PR's been handled. I don't understand how or why that picture was ever put out and I can't begin to think what was going through anyone's mind when they sent her out in that car. From a PR POV it has been appallingly badly handled.
However, if they'd decided they needed to put something out and it showed a woman looking a bit puffy (from steroids) or drawn (from pain) but still smiling with her DC, would that have been so terrible?
I understand of course that everyone wants to look their best, but from a PR pov, would it have mattered if an ill woman looked....ill?