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Well, you can 3D edit faces. It's very much the kind of thing you would only want to do for personal use, though, since it's a really fracking sloppy method. Basically, you just need to make a GEOM face slider that is, well, the face you want. Package up your slider (remember to do it for all ages and genders if you want the sim to age/breed properly), go in-game, set your slider to 100 and all others to 0. Instant face.
Like I said, though, it's half-assed. Might work as a once-off for a face you really, really, really want in-game but just can't get right.
What I lack in decorum, I make up for with an absence of tact.