That person in Fallout 3 was a plastic surgeon and it fitted with the world ethos and lore. It does not fit at all in TES and has no backing in the lore to justify it. If you create a character you are happy with to a the start you wont need anyway to change it. There is no need to rush through character creation.
As for respecs, this game does not need it. It is not an MMO where every skillpoint has to be perfectly placed. There are more than enough perk points to finish off any character build, and have plenty left to add to other non-build skills.
Lore, and back story in Fallout 3 was never needed to make a plastic surgeon fit into the game.
Lore, and back story in The Elder Scrolls would never be necessary to justify magicka to change your appearance.
It is as simple as telekinesis, or summoning. Simple magicka that can alter your appearance.
Mannimarco, king of worms was a master of resurrecting the dead, reanimating them, and giving them new life.
A simple addition of a master level npc mage who could cast a spell and allow you to change your appearance, wouldn't require lore.
Also, characters look entirely different, in-game than the mugshot during character creation.
There are many people who have started their games over due to being dissatisfied with their character's appearance.
Something like this is OBVIOUSLY a good idea, or beth would have never featured it in fallout 3.
It is a good idea for something to introduce into Skyrim. Period.