In the bowl of a stand mixer fitted with a paddle attachment or a medium mixing bowl using an electric mixer with a whisk attachment, beat cream cheese until smooth.
Add the vanilla, beating again. Add the powdered sugar in stages until it is a thick consistency.
If the mixture is dry and brittle, add small amounts of cream until it is soft, but holds its shape.
Transfer to a piping bag fitted with your desired tip. Only fill 1/3 of the way, it makes it easier to pipe.
Pipe out rosettes onto a wax or parchment paper lined rimmed baking sheet.
Allow to set for 1-2 hours at room temperature.
Store between layers of waxed paper in an airtight container in the refrigerator or at room temperature.
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Notes
If you'd prefer patties: Coat your hands with powdered sugar (it is sticky!) and shape into 1/2 inch. balls. Place on wax paper. Flatten with a fork. Let stand until firm, 1-2 hours.