Society puts a lot of pressure on women to look as good as possible so it is not surprising that you are so concerned about your appearance. Body dysmorphic disorder is an abnormal preoccupation with minor or imaged issues. One of the keys to the diagnosis is related to how much of your day is taken up by such preoccupations.
Recognize that aging is inevitable. Nora Ephron (Sleepless in Seattle) has a wonderful essay in a book of the same name titled: "I hate my neck." The essay is about her fears of having surgery based on how overdone women become even after having surgery by relatively famous plastic surgeons. Her advice is to love your youthful neck and take every opportunity to show it off. She had no idea at your age how great her neck was. The moral is don't get lost in obsessive thoughts, and enjoy what you have.
Now, lets answer you questions. First avoid surgery as much as possible. As great as I or my colleagues are as surgeons, every surgery is associated with unwanted side effects no matter how brilliant the surgery was performed. Unfortunately we live in a world were you will eventually find someone who will do what you are asking for whether it is the right thing or not. You need to learn to be your own best advocate. Protecting yourself from the unintended consequences of surgery is essential.
The suggestions of Dr. Kasden are very appropriate. Some people are under the impression that tanning beds are safer than tanning in the sun. The reality is that both are bad. A prescription for Retin A from your dermatologist for use every 4 or 5th night can be helpful-just don't over do it. Moisturizes are helpful in making the skin look better but that is all they do. Don't spend a fortune on them. Also, there is no scientific support for "staying well hydrated." People drag around big bottles of water and slavishly try to get their gallon of water a day. Your body is very good at conserving water and making you thirsty if you need more. So there is no reason to be a slave to the water bottle.
Finally, recognize that the images of your favorite actress or model are often manipulated in photoshop and then presented in a way that is designed to make us feel bad (so we buy the product they are selling). Try to keeps things in perspective and not drive yourself totally insane looking for perfection.