Joan Rivers always appeared happy as ever when she was alive, but the comedian battled a lot of inner sadness that caused her to change her appearance with plastic surgery.

The new book Last Girl Before Freeway: The Life, Loves, Losses and Liberation of Joan Rivers, written by Leslie Bennetts, revealed the emotional turmoil the late star faced that led her to undergo multiple cosmetic procedures (she once joked she had 739) during her lifetime.