If I had to guess, the alive picture is probably early 50s, so more like 15 years.When was the "alive" pic taken? Maybe 10 years back? Peoples face change. That could account for the nose. Even the ear.
I looked at a couple of these pics, and the ear changes look consistent with the age (cartilage becomes less springy), and more particularly lying on his back vs standing up.
I guess that's really all I have to say on the subject. I think they are consistent (closer than many of the hillary before/after fall pictures I have seen)