ROME - He is a former showman who often seems to relish attention and prides himself on his ability to connect with Italian voters.
But it has been about a month since Italy's prime minister, Silvio Berlusconi, embraced the public spotlight, a period of uncharacteristic invisibility and seemingly lightened activity that has spawned a flurry of rumors and questions.
The unusual situation was thrown into fresh relief yesterday when Berlusconi failed to meet with the president of Malta, Guido de Marco, who was visiting Rome.
Berlusconi sent Italy's deputy prime minister, Gianfranco Fini, in his stead.
An official with the Maltese Embassy said the original plan had been for Berlusconi to attend.
An aide to Berlusconi said the prime minister spoke at length with the Maltese president on the telephone yesterday and the decision to have Fini meet with de Marco was not a last-minute one.
While Fini had the meeting, speculation in Italy that Berlusconi was deliberately staying out of public view while he healed from cosmetic surgery grew louder.
Yesterday, the popular news weekly L'Espresso, a left-leaning publication that is often critical of the prime minister and his center-right governing coalition, distributed advance copies of an article on the topic.
The article, to be published tomorrow, states that the prime minister visited a clinic in Switzerland late last month and that a team of surgeons, including several from California, operated on his face and neck.
Berlusconi's aides declined to comment on the article, which follows similar ones in various publications over the past week.
The last occasion when many reporters got a long look at Berlusconi was at a news conference here Dec. 20. He left Rome on Dec. 23 and has spent much of his time since then at his villa on the island of Sardinia.
During those visits, he has been seen up close only by a limited circle of senior government officials.
Instead there has been a whirl of gossip about why. While most of it has focused on cosmetic surgery, there has also been some speculation that Berlusconi might be seriously ill. In the late 1990s, he had prostate cancer.
But his aides and associates have said repeatedly over the past week that Berlusconi is not dealing with any serious health problems. They have also said that he spent much of his time in Sardinia at work on government business.