I thought a thread with some tips might be helpful? I have used other ppls tips and I think my characters are more what I want them to be. Please add your own.
1. Turn up the brightness in the setting, change it back before you do skintone.
2. Pick the preset closest to what you want, get rid of hair,scars, warpaint and make-up.
3. Pick out your eyes, nose and mouth 1st, they will change slightly as you move other settings so pay attention.
4. Move the head around, you can't get a full profile on x-box, but it's very close. Remember to go up and down as well. Use the different screens to get slightly different perspectives.
5. When you THINK you have what you want, put the hair style on the character, change the brightness setting to what you will be playing at, leave the room and go do something for a couple minutes. ( I try for at least 10 min) You will notice things you don't like quicker that way.
As I haven't yet played Dawnguard I don't know the mechanics of the "plasctic surgeon", but if it works the same way with less options, some of these tips should help. Please feel free to add your own tips.