bloomberg.com What Happens When Someone You Love Changes Their Face? Alice Robb 10–12 minutes

“When the stranger’s face arrived to occupy my mother’s body, it shocked the language out of me,” recalls Linli, the 26-year-old narrator of Sarah Wang’s debut novel, New Skin (May 12, Little, Brown). The stranger was her mother, Fanny, transformed by a face-lift and a nose job. Linli was 8 years old, and she was so disturbed that she regressed: Her grades slipped, and she stopped speaking. “I recoiled when she came near me.”

A spate of new fiction and TV is making room for an underexplored perspective: that of the families and partners of plastic surgery patients. Parents, lovers, children and friends bristle at seeing their loved ones eliminate familiar quirks — and, with them, evidence of a shared history. In New Skin, Fanny’s original face is so bound up with Linli’s earliest, defining memories that she comes to feel that the surgeries have robbed her of her “real mother.”

In Amy Wang’s 2025 movie Slanted, Joan, a Chinese-American high school misfit, spends endless hours on social media, admiring her blond-haired, blue-eyed classmates and filtering her own face through an app called Ethnos. When she’s offered experimental surgery that will make her look White, she doesn’t hesitate (or ask any follow-up questions, like, “Why does this surgery take place in the backyard of a strip mall?”)

Joan is thrilled with the results, but her parents are aghast and threaten to call the police when a White teenager unlocks their door. They eventually accept that the body-swapped version of Joan is still their daughter but lament what they see as her rejection not only of herself, but of them. In one scene, Joan’s father sobs that he used to see his mother’s eyes in his daughter’s face.

In Matthew Hodgson and Ryan Murphy’s 2026 series The Beauty, a scientist discovers “a one-shot, one-size-fits-all cure for everything” — a virus that transforms the middle-aged and genetically unlucky into physically perfect specimens. A crusty billionaire named Byron Forst wakes up in the body of Ashton Kutcher; a chubby incel turns into Jeremy Pope.

The “Beautified” are unrecognizable to their friends and family, but that trade-off, in the craven world of The Beauty, is no big deal. Meanwhile, when FBI agent Jordan Bennett (originally played by Rebecca Hall, who is 43) greets her best friend and lover, Cooper, after accidentally contracting the virus and turning into Jessica Alexander (26), Cooper’s chin wobbles, and he insists that she’d always been beautiful to him.

The emotional risks of cosmetic interventions are real. A growing body of research suggests that wrinkle relaxants may interfere with the ability to communicate feelings and, more important, with empathy itself. In one study, people who’d had Botox felt less fear than untreated subjects when shown footage of a man eating a sausage containing live worms, and they were less amused by America’s Funniest Home Videos. Another found that people who’d received Botox injections in the forehead were less able to perceive anger on another person’s face. In New Skin, Fanny’s eyelids are so mangled from repeated surgeries that she loses the ability to cry — a real, though usually temporary, side effect of blepharoplasty.

A 2018 study of almost 2,000 bariatric surgery patients in Sweden found that those who were married at the time of their operation faced an elevated risk of divorce. After Byron Forst’s transformation, he and his wife, Franny (Isabella Rossellini) are not only emotionally distant — they dine at opposite ends of a table long enough for a banquet hall — but also physically mismatched. “What kind of joke is that?” Franny asks when Kutcher comes home claiming to be her husband. “The only joke here is that someone as good-looking as me could still be married to you,” Byron replies.

The interpersonal alienation is ironic given that a common motive for cosmetic surgery is the desire to belong. Patients are striving to conform to the ideals of a group that may never accept them, whether a race, as in Slanted, or a professional class, like the supermodels in The Beauty.

In New Skin, Fanny is a Chinese immigrant who longs to fit in with her colleagues at a California nail salon. Her first eyelid surgery soon leads to another procedure, and another, until her face resembles — in the harsh gaze of her daughter — a “scrambled egg.” Yet what finally gives Fanny a measure of peace is finding community among other recovering plastic surgery addicts.

Disfigured by years of bargain-basement procedures, Fanny joins the cast of a reality TV show, America’s Beauty Extreme, in which victims of botched surgery compete for corrective work. After displaying a disarming self-awareness during the show’s group therapy challenges, Fanny wins the $200,000 prize. But instead of spending it on more surgery, she gives the money to Linli for graduate school tuition and returns home with a new outlook. “I don’t stay up at night thinking about the next procedure I need to get anymore,” she tells Linli. “I made real friends.”

The acceptance that comes from artificially optimized looks, meanwhile, is depicted in films like The Substance as fleeting and untrustworthy. “We love you!” “You will always belong here!” TV network executives call out at dancer Sue (Margaret Qualley), as she struts toward the stage to host a New Year’s Eve special. (Sue is the pert, 20-something clone of aging actress Elisabeth, played by Demi Moore.) But when Sue’s body begins to disintegrate minutes later, their cries change to “Shoot the monster!” The crowd — so recently adoring — charges the stage, attacking her. “It’s still me,” the creature wails as she collapses.

Over the past few years, as this genre of face horror has emerged, cosmetic surgery and weight loss injections have become increasingly safe and affordable. According to the International Society of Aesthetic Plastic Surgery, almost 38 million aesthetic procedures were performed globally in 2024, a 40% increase from 2020. In November 2025, research from health policy researcher KFF found that roughly 12% of American adults had used GLP-1s.

Much of the stigma has also faded: Body modification is now widely framed as an expression of autonomy and empowerment. Celebrities who once insisted their looks were natural now proudly share the names of their surgeons. When Kylie Jenner divulged the details of her breast implants in a TikTok comment (“445 cc, moderate profile, half under the muscle!!! silicone!!!”), fans called her “iconic” and praised her “transparency.” A few months later, gymnastics champion Simone Biles revealed her own breast augmentation on TikTok, drawing comments like, “You are awe-inspiring” and “Good for you for doing what makes you feel good!”

Even as body modification has become more normalized, some are quietly hoping for a backlash. GLP-1s have been prescribed since the mid-2000s, and patients are overwhelmingly happy with them. But many people remain skeptical that thinness can be achieved without strenuous effort or hidden consequences. “It’s gonna backfire, something bad is gonna happen,” comedian Chelsea Handler — who reportedly works out with a personal trainer five or six days per week — said of the drugs. Reality TV star Bethenny Frankel, founder of a low-calorie cocktail brand, issued an ominous but medically unfounded warning on Instagram that the side effects from GLP-1s will not become clear “for months and years to come.”

And though plastic surgery disasters are highly publicized (New Skin’s fictional America’s Beauty Extreme resembles the reality show Botched, which invites viewers to gawk at, for instance, a model with 30-pound breast implants and a woman who had tire sealant injected into her face), research suggests that most cosmetic surgery patients are ultimately pleased with their results. A 2023 study found that 85% to 95% of women who underwent breast augmentation were happy with the outcome. And a 2024 review of 380 rhinoplasty patients found that 89.5% were more satisfied with their appearance six months post-op than they’d been beforehand.

Fiction offers a safe place to explore our anxieties about these new possibilities and to indulge the Protestant instinct that self-improvement ought to involve suffering. Results that initially seem miraculous inevitably expire in a moment of humiliation. In Slanted, Joan is accepting her title as prom queen when her skin begins peeling off in waxy clumps. In The Substance, Sue’s face starts to dissolve under the spotlight. And in The Beauty, frumpy people become hot for two years — then they spontaneously combust. In fiction, we can indulge the suspicion that these shortcuts are wrong, that this is gain without pain. These are fantasies of revenge, punishing the transformed for not suffering enough.

While watching The Substance — an experience I hated so much, I had to spread it over several days — I kept thinking about another famous body-swapping film. Freaky Friday, which came out in 2003, is warmhearted and charming where The Substance is sterile and mean-spirited. It doesn’t dwell on the physicality of Lindsay Lohan and Jamie Lee Curtis trading places; the film is more interested in what a frustrated teenager and her harried mother can learn from each other’s perspectives. Alas, it was a simpler time. In the 2025 sequel, Freakier Friday, teenage Lily wakes up as her step-grandmother Jamie Lee Curtis, looks in the mirror and screams, “She just has crevices all over her face! Look at the crevices!”

Alice Robb is a writer in London. Her latest book is Don’t Think, Dear: On Loving and Leaving Ballet.