His ears are definitely different. He may have had a slight brow lift to remove his usual scowl that all of his other photos have, even when he’s smiling. He either had a stroke and/or it was an excuse to get some work done on his off-putting appearance. His cranium looks different as well, but camera angles can be deceptive.
This would explain why he was kept out of the public eye for so long -to recover from the extensive plastic surgery he had so people would stop talking about stupid Pensylvania for electing a brain damaged Neanderthal to office.
(no offense to those who didn’t vote for him.)
You could be right about the plastic surgery.
Designed to increase his popularity in looks-conscious D.C.?
Giselle wants to get invited to the right parties.