And while those comments may be a bit extreme, there is no doubt that her nose has taken on a different shape, around the time of 2004.
The only clear explanation i can think of is plastic surgery, unless she had a horrible unreported sporting accident of some sort.
But lets be realistic here, the before and after pictures are pretty concrete evidence of a good ol' fashion nose job.
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And i also have a feeling this wasn't her only plastic surgery operation...