What is going on with the side of his face?
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He has furrows that appear to possibly be surgical scars.
The picture sorta sucks, I'll enhance what I'm talking about:
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I'm certain they aren't artifacts. They sorta follow the facial vasculature, but that would be very unusual for someone his age and obesity. I've seen facial features like that on people 70+ that are somewhat thin. Also, notice those darker points along the lines? Those could easily be where surgical monofilament was tied/knotted. I've seen tracts like that on people that underwent facial reconstruction after an auto accident. In auto accidents that involve windshield/glass you can get strangely shaped injuries such as where glass was embedded or sliced the skin full thickness.
What does the rest of the hive mind think?