I'd hope so, I'm usually never happy with how my characters first look and constantly start over to get that certain "look" I want.
Its very likely we will.
Todd said in an interview about how dumb he thought it was the first choice you make in Skyrim, what your character looks like, couldn't be changed at all, which is why he added the face sculptor in Dawnguard.
I would be surprised if such a thing wasn't in the game by default in Fo4.
Convienences like these, once added aren't usually removed.
u could do it on Fallout 3 with the dude that change the face on the android so i guess u will be able to do it.
I don't think it's going to be as much of a problem in 4 as it was in 3 and NV. The new character creator gives you a much better picture of what your character is going to look like, if only because it's not on a dark, tiny screen. The first character I created in NV looked like a Johnny Depp claymation nightmare.