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This picture is with no makeup and I'm tired, but...

This picture is with no makeup and I'm tired, but I feel it's a pretty accurate representation of what I look like. As you can see, I have an adult acne problem; I've been battling this for the past five years. I believe all the topicals and oral medications that I have tried have caused premature aging. Other than my skin issue, I am interested in getting a nose job - my nose is super crooked! Now, what do you think about my eyes? I've been thinking to get an eye lift at the same time of the nose job. Not sure.