The Utah doctor accused of killing his wife made his first court appearance Monday and came face-to-face with his daughters, who say they believe their father had a plan to kill their mother.
Martin MacNeill, 56, was formally charged in the death of his wife, Michele, in April 2007. MacNeill has been held on $1 million bond at Utah County jail since Friday, and is due to return Sept. 4 to choose an arraignment or an evidentiary hearing.
He has denied the allegations.
Two of his daughters and other family members held up pictures of their mother as they glared at their shackled father in the Provo courtroom.
"She [Michele MacNeill] means so much to so many people and this is who he took away from everyone, this is our mother," MacNeill's daughter, Alexis Somers, said outside court.
"I think he drugged my mother and drowned her. It's been horrifying, and horrifying that we had to wait for this day so long."
An initial autopsy report stated that Michele MacNeill, 50, had died of natural causes eight days after having a facelift. Authorities now believe Martin MacNeill drugged and drowned his wife, who was found unconscious in the bathtub. Prosecutors believe MacNeill gave his wife a dangerous combination of valium, Percocet and Ambien in an alleged plot to kill her.
"He created circumstances that would have otherwise been somewhat unusual and point to guilt," ABC News legal analyst Dana Cole said. "The initial determination of natural causes can change if circumstances develop."
It's a twisted family tale that began when MacNeill, a father of seven, turned 50. His daughters said he became obsessed with his looks and started to tan and exercise. Their mother began to suspect an affair. Then, MacNeill focused on his wife's looks, insisting she get a facelift.
"He had a plan to murder my mother, and this was just part of his plan," Somers said.
While caring for her mother after the surgery, Somers said, she heard a bombshell days before her mother died. "A few days before her death, I was helping her wash her hair and she turned to me and said, 'Alex, if anything happens to me, make sure it was not your father,'" Somers said.
On the day Michele MacNeill died, Martin MacNeill had arrived home after picking up his then 6-year-old daughter from school. They found Michele in the bathtub.
In a series of screaming 911 calls, Martin McNeill hung up on the operator three times in five minutes. During that time, prosecutors say, he removed his wife's pants, lied to the dispatcher about performing CPR and gave the wrong address of his residence, further delaying emergency responders.
"We know he's guilty," daughter Rachel MacNeill said. "We know he'll harm again. If he's let out, he will come after us."
MacNeill's attorney, Randy Spencer, said, "He's adamantly professed his innocence from the beginning and continues to do so. I'm confident when all the evidence is heard that the jury will conclude he's not guilty."
After five years of fighting for justice for their mother, MacNeill's daughter's say they will spend every day in court until justice is served.
"This is going to be a struggle but we know the truth," Somers said. "We know he killed our mother."
The doctor and former Mormon Sunday school teacher had served three years in a Texas federal prison for fraud and was released in July.
ABC News' Jennifer Pereira contributed to this report.