Modern FiveM skin creators utilize a "blend" system inherited from the base GTA V engine, which allows for unique facial structures rather than just static presets.
If you want to move beyond preset options, you can create and stream your own custom clothing: Make Your Own FiveM Clothes - EASY TUTORIAL skin creator fivem
Allows players to Save, Update, Clone, and Delete character profiles. Modern FiveM skin creators utilize a "blend" system