She has gained a lot of muscle, but she's had facial work done, no doubt. A good plastic surgeon makes it look natural, but she has certainly had her face touched up.
Since she was shit poor and supporting her family with shit jobs while putting herself through the indies (she spend her high school years living in motels and the family car) it can't have been done prior to her joining WWE, she still has the extact same nose, eyebrows, cheekbones and chin since then.
But do tell, what did she have done in your opinion?