It would be just as ''lame'' as having plastic surgery while nobody sees the difference.
Your forgetting all the dialog that would have to be added to the game to support a situation where NPCs no longer recognize the PC. I hardly call that a lame decision.
In Fallout 3, there was an NPC that got plastic surgery, so it was in the game. There were surgical instruments and doctors all over the game so one would expect to be able have this done. Cybernetic Implants were offered, Adamantium Skeletons were offered. It is not a leap to offer plastic surgery in Fallout.
Where has any surgery ever been mentioned in any TES game? Where are the surgical item clutter in TES games? What NPC is a surgeon in TES games? We might as well introduce guns and stimpacks and hypodermic needles/pills rather than potion bottles just because it was in Fallout 3.
Different games, different worlds, different technologies, different rules.


