Shania Twain's return to public life has sparked speculation about her drastically changed face.

The 59-year-old Queen of Country hosted the People's Choice Country Awards last month, where she wore a Barbie-inspired denim outfit and a blonde wig.

However, many fans said it wasn't just her hair and makeup that looked different. Some described her as “unrecognizable,” while meaner commenters said she looked “like a Muppet,” a reference to the children’s show.

Dr. Gary Motykie, a well-known plastic surgeon from Beverly Hills, California, told DailyMail.com that while Twain looked “great” for her age, he saw several signs that she may have had cosmetic improvements.

He said her lack of lines and “more open” eyes suggested she may have had a brow lift, a procedure in which an incision is made behind the hairline to lift and tighten the skin, smooth wrinkles, and the like To reduce sagging.

He also suggested that the lack of wrinkles could be due to the use of Botox, saying her fuller face in previous pictures suggested she had used fillers.

He added that her dramatic costume made him suspect some work had been done because celebrities can do this to distract from cosmetic changes.

“It’s an effective way to shift focus and encourage people to speculate,” he added.

“In recent years, Shania Twain has been known to use wigs to completely transform her appearance, regularly reinventing herself.”

“In the world of celebrity plastic surgery, we have also noticed that dramatic hairstyles are increasingly being used to distract from changes that may have resulted from going under the knife or treatment with dermal fillers and Botox.”

Dr. Adam Rubinstein, a plastic surgeon in Miami, Florida, told DailyMail.com that he suspected Shania had undergone blepharoplasty, also known as eyelid surgery.

“Shania has beautiful cheekbones and a great jawline, she's just naturally well-structured and ages particularly well,” he said.

“But the one thing I see is that her eyes look really refreshed, especially the upper lids.

“Her upper eyelids look a little fuller and heavier before, but then when you look at the People's Choice Awards, they look a little more open and brighter.”

He added: “It may be make-up, but it looks like an upper eyelid lift – or blepharoplasty – is possible because they look so refreshed.”

Shania has denied having had any plastic surgery, telling The Sun in May at the start of her third Las Vegas stay – Come on Over: “Every month or day that I notice another bit of sagging or another bit of cellulite, I want to know that it's there.”

“I want to be okay with it instead of thinking I have to cover it up or not look at it.” I can't change it and don't plan on changing it superficially.

“I need to go on stage without feeling like I have to cover myself up. I want to feel liberated.”

In January this year, she also denied the rumors on the Hoda Kotb show, saying she loves her “own skin.”

DailyMail.com contacted Shania's team for comment.

After she debuted the new look at the People's Choice Awards, fans on social media were quick to comment, “No way, she's not Shania.”

A second added: “Until I read it was her I couldn't recognize her,” and a third said: “Plastic surgery ruins what was once a beautiful face.”

Surgeons also compared photos of Shania from 2008 and the late 2010s to suggest she may have had filling therapy.

Dr. Motykie said: “I think that some people in her situation and a lot of people as they get older want to try things that don't require incisions and major surgery.”

“So they're starting to play with things like injectable fillers and Botox to try to get rid of loose skin without tightening it or leaving scars, and in many cases it's causing overcrowding.”

“They do a little and a little more, and then the filler starts to absorb water and they look chubby.”

Dr. Rubinstein also suggested that her wrinkle-free appearance was probably helped by Botox, and he suggested that she may be maintaining her lips with filler.

But he disputed suggestions that she had used filler on the rest of her face, saying: “The kind of puffiness we see with filler usually occurs in certain areas and I don't see that with her as she generally looks fuller.”

“The puffy appearance could instead be due to weight gain.”

Dr. Christopher Costa, who runs Platinum Plastic Surgery in Las Vegas, told DailyMail.com that he believed the initial changes in her appearance were due to weight gain.

“I agree that her face has changed drastically in the last decade, from a fuller and rounder look to a much more sculpted and sharper look,” he said.

“However, in my opinion, the changes in her face are more related to general weight changes.”

In 2018, Shania underwent open neck surgery to repair her vocal cords after her nerves were damaged by a Lyme disease infection.

The superstar said the illness left her unable to produce her voice for seven years and she was “petrified” of going under the knife to fix it.

She told Britain's Graham Norton Show in 2023: “I'm just grateful, to be honest.”

“For a long time I thought I would never be able to sing again or that I wouldn’t be able to cheer so loudly at a sports game.”

Shania is famous for her health and fitness regime that has kept her body in tip-top shape for decades.

Shania revealed her diet in May this year, saying she is a vegetarian and only eats liquids like spinach and blueberry shakes before her shows.

She also works out three to five times a week and says she enjoys playing tennis – with the court being her gym.