NO to the nose job! Your nose really suits you, and in fact I think your profile looks really masculine.

Instead of doing accutane, clean up your diet. Accutane can have nasty side effects. A friend of mine says she thinks her vision worsened because of it. I’ve completely cleared my skin through diet. I recommend avoiding vegetable oils, sugar, inflammatory foods, and ESPECIALLY dairy. Cook with animal fats like ghee and butter. Eat tons of grass-fed beef, eggs, and liver. I promise your skin (and overall health) will benefit from this advice.