The things that I spot that I notice that seem off are:

• His left inner eye (right side in our view) has a dark black hole that makes no sense unless it is a mask.
• the 3 horizontal wrinkles atop the bridge of his nose. Who get wrinkles that way? Most get vertical frown lines (called '11's). He has none of those.
• this angle of shot you can see his ears on the left side of the photo, but cannot see his ears on the right side of the photo (his left side). In every other photo I can find of Joe with this angles, his ears are prominently sticking out and visible (both) when looking forward with slight oblique angle.
• He has his blue eyes again. Many videos of him recently show him with the dark red/black irises. This time, back to baby blue.
• He doesn't have the cleft chin here that he's been sporting (ball sack Joe) as seen in recent appearances.
• He appears to be smiling with a straight across smile instead of the crooked smile he has in many photos i.e., his right side pulls up more, showing more teeth / gums.
• Ear lobes are attached on both sides (again, could be from previous face lift)
• Skin texture very smooth and wrinkle-free, and especially his deep forehead lines are now just thin, light wrinkles. Could be from Botox, but... quite smooth for a person of that age
• Face has makeup on it - removes imperfections on camera. That is expected