There are a number of skin and shape designers that will try to accomodate you with custom requests. Usually it will cost you quite a bit for custom work, especially for skin creators. I have been doing custom avatars in SL for 6 years and can help you out for most requests. I accept donations for copy mod shapes, but charge 4000L for full perm shapes (those are transferrable and usually bought by skin designers to go with the skins they sell). IM me in world and I am happy to see what you need .
As for skins, I know most of the new skins in SL and can help you find one that suits your needs!
Zaria Noel