Anastacia is adamant her use of Botox will continue, saying she looks 'scary' without it.
The multi-award winning songstress who has enjoyed a decade of international success with hits including I'm Outta Love and Not That Kind, first started having the injections to her forehead in 2003.
The 41-year-old told Reveal magazine: "Without it my frown scares me, let alone everyone else! I get it from my mum who has a perma-frown. It's a family trait. So I prefer to get rid of it with Botox in two places on my forehead."
The Chicago-born singer admitted her health battles have affected her confidence. She suffers from a rare heart condition and has battled breast cancer and digestive disorder Crohn's disease.
But she doesn't rule out going under the knife in the future saying: "I would have cosmetic surgery if I felt I needed it".
She added: "Everything I've been through has affected my confidence. It's all chiselled away at my core. But there's always a bit of putty to mend it."
Despite this the singer, who is a judge on Five's new talent show Don't Stop Believing, is looking forward to her impending 42nd birthday, and feels these days she's developing a better sense of self-acceptance.
"When I was a teenager I was a tomboy and the ugly girl of the group. I still kind of think that way, but I'm happier now when I catch sight of myself in the mirror. I'm definitely growing more comfortable in my skin".