Tsukushi was born on December 28 to middle class parents, Haruo and Chieko Makino. Her parents named her after a weed, because "it always grows back stronger than ever". Tsukushi's brother, Susumu was born around two years later. During her childhood, Tsukushi did not have many toys and her mother often had her play outside to save money.
She was a class officer at N Middle School, where she met her best friend, Yuki Matsuoka. Tsukushi was very popular among her peers in middle school. Her friend, Shingo Oribe confessed romantic feelings toward her during this time, though she never replied.
Tsukushi's mother forced her to attend Eitoku Academy, though Tsukushi preferred the public high school. After entering Eitoku, she became withdrawn in an attempt to remain "quiet and unnoticed." Despite this, Tsukushi befriended another middle-class student Makiko Endo, who was in the same class.
Meeting the F4
"I'm not letting you get away with this anymore! This is my declaration of war!"
One day, her friend Makiko slipped down a flight of stairs and landed on Tsukasa Domyoji, leader of the F4. Tsukasa refused to forgive Makiko's mistake, which prompted Tsukushi to protect her friend. Instead of Makiko, Tsukushi received the F4's red slip in her locker the following day. Tsukushi delivered red slips of her own to the F4, deciding to fight against their tyrannical rule. The following day, the other students began bullying Tsukushi and Makiko avoided her. Tsukushi held back her tears until she reached the emergency stairwell, where she spoke to Rui Hanazawa for the first time. Later, Tsukasa hired four students to assault Tsukushi. Rui stepped in and stopped them, despite previously saying "I'm not interested in other people's problems."
After the incident, Tsukushi returned to school with a vengeance. She blocked all of the others attempts to bully her and kicked Tsukasa in the face, before running away. Later, Tsukushi tried to thank Rui for his help, though he rebuffed her. She began to become popular among the students, eventually leading Tsukasa to kidnap her. He brought her to his mansion, where he had his servants give her a spa treatment and makeover. Tsukasa offered to "let [her] hand around him," which she rejected saying "I'm not for sale."
Back at school, she found "Tsukushi Makino, only girl in her school who had two abortions" written on her classroom's blackboard. Tsukushi confronted Tsukasa first, thinking he was the culprit. Upon returning to her classroom, she saw Yuriko Asai, Minako Yamano, and Erika Ayuhara wiping away the words. They invited her to a party, which she attended later that day. However, they humiliated Tsukushi, because of her interactions with the F4 particularly Rui. Before leaving, Tsukushi embarrassed Yuriko in front of a potential suitor by pouring champagne on her.
Tsukushi had copper colored hair and eyes. During her first year of high school, she often styled her hair in shoulder length braids. After confronting the F4, Tsukushi stopped wearing her hair in braids, leaving it down most of the time. Her hair remained straight and shoulder-length, until part of it was cut by Junpei Oribe. Tsukushi then wore her hair as a short bob-cut.
In the 1995 film, she is portrayed by Japanese idolYuki Uchida. Uchida plays Tsukushi as a stubborn, lower-class student attending Eitoku Gakuen University, similar to the original. The story starts with Tsukushi angering Tsukasa by refusing to join his fan club. She falls for Rui Hanazawa at the beginning, and slowly becomes friends with Tsukasa. She betrays Tsukasa's feelings, after embracing Rui at the beach, after she agreed to be the former's girlfriend. At the end of the film, Tsukushi realizes that Rui is meant to be with Shizuka and she reunites with Tsukasa.
Mochida also voices Tsukushi in the short film, Hana Yori Dango: The Movie (1997). In the film, Tsukushi is an aspiring dancer on Broadway, instead a high school student. Tsukushi works an errand girl at Freedom Dance Studios by day, while training hard at dancing by night.
In "The Bored Prince", a short comic published in Hana Yori Dango FF, Tsukushi appears as a frog in Rui's dream. Rui, a sleepy prince, finds and names her Piyon (ピヨン,Piyon). The frog informs him that she used to be human, however Rui wakes up before he can help her.
Mao Inoue portrays Tsukushi in all nine episodes of the Japanese drama, Hana Yori Dango (2005). Tsukushi lives in a small apartment with her family and works at a confectionery with Yuki. In the first episode, Tsukushi stands up to Tsukasa to protect Sakurako and later punches him, which causes Tsukasa to fall for her. She falls for Rui early on, but encourages him to go after Shizuka anyway. Tsukasa and Tsukushi grow closer, after a being trapped in an elevator. They are almost torn apart, when risque photos of her with a stranger are posted around the school, though Tsukushi is proven innocent. Confused about her feelings, Tsukushi takes Tsukasa on a double date, which ends badly when he punches Yuki's boyfriend. The misunderstanding is eventually cleared up and she apologizes to him. Meanwhile, several financial misfortunes befall her friends and family. Tsukasa and Tsubaki suggest she enter the Teen of Japan contest for the prize money and win their mother's respect. Tsukushi enters, but loses to Ayano Kurimaki in the last round. Tsukasa, having lost the wager with his mother, has to leave to go to New York. At the airport, the two confess their feelings and start a long-distance relationship.