I tend to "clean up" photos of myself, but I usually see it as correcting the photo to look more like the real me (at least, on a good day). For instance, I'll work on the colors, particularly making my hair redder if the picture was taken at the most-faded point of my dye cycle (but that isn't necessary if it was taken not too long after a dye job). That kind of thing. Sometimes, though, I'm just lucky -- the icon I'm using wasn't touched up at all, beyond normal color/contrast/light balancing.

The face shape changing reminds me of Scott Westerfeld's Uglies -- excellent book.