Lizzie Rovsek’s come a long way from her days of growing up in the heartland of the country. After being born and raised in Columbia, Kentucky, the brunette beauty went on to compete in numerous pageants, including vying for the title of Miss USA.

These days, the 34-year-old lives in Ladera Ranch, California and is the newest castmate of the Real Housewives of Orange County. She’s married to real estate executive Christian Rovsek, is the owner and head designer of Sun Kitten Swimwear, and has two sons under the age of 4.

RHOC wasn’t the first thing to earn Lizzie some headlines, however. Back in 2006 (when she was still known as Lizzie Arnold), the former Miss Kentucky was thrust into the spotlight when she briefly dated Nick Lachey after he separated from Jessica Simpson. Even more strange is the fact that Lizzie competed in the 1998 Miss Teen USA pageant against Vanessa Minnillo, who just so happens to be Nick’s now-wife!

A lot has changed since Lizzie was hooking up with the singer, and perhaps most obvious is the way she looks. In comparing photos from 2006 to the present, it’s hard to deny that Lizzie’s had a bit of work done. (Then again, which Housewife hasn’t?)

According to plastic surgeon Dr. Anthony Youn (who hasn’t treated Rovsek), Lizzie’s most likely had a nose job and possibly more.

“Her nose appears to be moderately thinned, likely from a rhinoplasty or nose job,” Youn told RadarOnline. “These types of nose jobs can reduce the appearance of ethnicity, but has also made her look more elegant. Kudos to her plastic surgeon!”

If you ask us, Lizzie’s lips also look visibly fuller — but that could just be the result of a high-powered plumper!

Are you surprised by how much Lizzie has changed? Do you think she’s had more work done than just a nose job?