It depends...
If it is for a particular story like my military sims, I'll go to the length of adjusting the base military uniform in TSRW.
https://4.bp.blogspot.com/-1LnegxIpsMQ/W0zyhAwd86I/AAAAAAAAVus/qzTEPYmIBvgMBDpZ4e7hUJ3U2l1PExZjACLcBGAs/s1600/Screenshot-138.jpg
Otherwise, sometimes, I just work with what's available in base game and EPs.
Didn't particularly care for the color of the blouse and I really didn't like the maid outfits so I matched the recolored blouse with a business skirt (color-wheeled the pinstripes out) and used that as a maid-outfit.
https://1.bp.blogspot.com/-amg3o-kxhmU/W7UCT6aBNHI/AAAAAAAAYtg/H2Nhrd_U1EUt1uITQ7HCAT195hLuXBoyACLcBGAs/s1600/Screenshot-109.jpg
And yes, I've been known to go crazy on TSR. Sometimes I'll camp out there for hours. I don't know how I explain this to my wife... :smirk: She spends less time on TSR than I do.
As for hairstyles, depending on the story, I'll resort to cc or stick with EA game hair depending on the character.