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Carrie Underwood attended an American football game in Las Vegas over the weekend, looking sensational in a leather top and ultra-short shorts, and while her outfit was gorgeous, fans also commented on how the 40-year-old looks a little different.

Comments on the beautiful photos of the American Idol singer at the game saw fans wondering why she looks different, with many querying if she's had plastic surgery to change her looks. "She’s still as beautiful as always but I didn’t even think this was Carrie!" one commented on how the star looks different.

Other fans were quick to explain the change in Carrie's looks, writing: "That's what 17 stitches from a fall do to you. Makes you look a little different," while another commented: "She’s also older. Do you look the same as you did five years ago?"

Indeed, Carrie had to have a lot of work done on her face following a fall in 2018. In a statement at the time, Carrie said she had: "40 and 50 stitches," to her face.

Carrie fell on the steps of her house and later warned her followers that she may look "a bit different" when they saw her again.

"Even though I’ve had the best people helping me, I'm still healing and not quite looking the same," she told her fan club in January 2018.

"I honestly don't know how things are going to end up but I do know this: I am grateful. I am grateful that it wasn't much, much worse."

Fans did note that her accident was a while ago, and with Carrie looking fresh-faced and beautiful, we turned to aesthetic doctor Dr. Sabina Hanoman-Singh, of the CREO Clinic for her professional opinion on the plastic surgery Carrie has had.

What surgery has Carrie Underwood had?

"Carrie Underwood looks great and whilst we don’t know if she has had any treatments to enhance her looks, it looks as though she may have chosen some anti-aging and natural enhancement procedures to maintain her youthful look gracefully," confirms Dr. Sabina.

"Starting with her upper face, she may have had anti-wrinkle injections. These injections can smooth out forehead lines, frown lines, and crow's feet while also preventing new wrinkles. They can give the forehead a smooth and fresh appearance and subtly lift the eyebrows, as you can see in her photos," Dr. Sabina says.

Carrie Underwood's bright eyes

"Carrie's eyes, both upper and lower, seem smoother and firmer, which could be a result of collagen synthesis treatments. These treatments might include things skin boosters that provide essential building blocks for collagen, antioxidants for brightness, and hyaluronic acid for hydration and plumpness.

"She might have also tried other treatments such as laser therapy or regenerative treatments such as polynucleotides to stimulate her skin to produce more collagen and elastin. Often, a combination of these treatments works best to make the skin plumper, smoother, and tighter," Dr. Sabina says of Carrie's youthful looks.

REVEALED: Carrie Underwood uses this game-changing $16 face cream for flawless skin

"The lines around Carrie's nose and mouth appear less noticeable, which can happen with a mix of treatments. Some involve filling lost volume with dermal fillers made from hyaluronic acid, while others focus on tightening with collagen synthesis treatments like laser therapy."

Has Carrie Underwood had lip filler?

"Carrie's lips look hydrated and plump, which might be from dermal filler treatments using hyaluronic acid gel. Her smile also shows less gum, possibly because of anti-wrinkle injections around her mouth, which can reduce the muscles' pull when smiling," explains Dr. Sabina.

RELATED: Lip flip: The 30-second tweakment for fuller, poutier lips 

Has Carrie Underwood had anti-wrinkle injections?

Dr. Sabina continues that Carrie's lower face and jawline maintain a youthful shape, perhaps due to the collagen synthesis treatments mentioned earlier. "Anti-wrinkle injections in the lower face could also help by preventing sagging in the mouth corners, jawline, and neck muscles, giving her a lifted and refreshed appearance."

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