They eventually (July 2009) added a Cosmetic Surgeon in the Superscience Super Booster. It allowed you to change every aspect of your character, up to and including gender at any Icon/Facemaker (tailor) location. Those changes were costume specific, thus you could have a character that's was female in one costume, male in another, giant in a third, and so forth. They also added this to the Paragon Market after the game went F2P as a stand-alone purchase in addition to remaining in the Booster.
As far as the costume goes, that's the way all MMORPGs should work, in my opinion. You should be able to look exactly like you want to at all times, not be a slave to the RNG. But that's just my opinion.