Hey @kkrumm this is what it should look like:
https://osticketawesome.com/1.10.1/scp/profile.php
The button below the picture allows the user to create a new random composite. It is kind of like playing a slot machine. This is in lieu of using a profile picture through Gravatar.
Do you still have a vanilla osTicket installation on your server? If yes, would you mind looking at your profile page in the vanilla osTicket and letting me know if the button shows up or not? Thanks!