So... Im stuck with the orignal Fallout 3 for the time being. But um, I can go to Rivet city and get my face changed? Who do I go to?

you need to talk to dr pinkerton in the broken off front part of the ship, and its not gonna be easy probably for you if you never talked to pinkerton before. its a bit tricky getting into the front part of the ship.

How does one get to the front of the ship?

well there is adoor on the side of the front part of the ship, you need a lockpick skill of 100 to open it from the outside, but the other way in is underwater through a corridoor type thing, its right below the surface of the water at the section where the front part of the ship is broken, just jump in the water and head toward the broken part, now most people trying this the first time or two end up drowing, but there are air pockets if you swim up, you have to go through this corridor thing, near the broken front section of the ship, after you go through the corridoor, swim up for the air pocket, its a big air pocket, if you do that you won't drown, but anyway there is adoor or two you need to go through and just rememer to swim up for the air pockets.

Don't bother going if you haven't done The Replicated Man quest far enough to get referred to Pinkerton; he won't offer his cosmetic surgery services if you haven't gotten that far.

you can also use showplasticsurgeonmenu in the console

And you don't need to go to Rivet City in order to get your face changed. If you have the Megaton home then your robot can do it for your and there's another person in the Museum of History who can do it as well. I've never played the Tenpenny route but I suspect there's someone/something there that will do it as well, just like with the Megaton home.

The house robots and Snowflake (along with Butch and that Lamplight brat) only offer haircuts. Pinkerton is the only one in game who offers facial reconstruction.

I see. I've never bothered using any of those services so I wasn't aware there was a difference. I just presumed they were all the same as the character creation screen.