Netflix’s Uglies has viewers wondering more about the Transformation, a mandatory and extreme cosmetic surgery that dominates the dystopian story’s world. Based on the best-selling young adult book by Scott Westerfeld, Uglies features a cast of characters led by Tally Youngblood (Joey King), a teenager on the cusp of receiving her long-awaited surgery. Tally’s best friend, Peris (Chase Stokes), is set to receive his surgery a few months before Tally, which means they’ll be living in separate worlds until Tally’s birthday. However, things don’t go so smoothly for Tally.

Missing Peris, Tally decides to sneak into the Pretties’ beautiful city across the river. Although she manages to see Peris, Tally isn’t happy with what she discovers. In addition to being a Pretty on the outside, Peris doesn’t seem to value their long-standing friendship anymore. When Tally flees the Pretty compound, she runs into a fellow member of the Uglies, Shay (Brianne Tju), who tells Tally that the stories of a rebel named David (Keith Powers) living in a place called The Smoke, well outside Pretty society, are true. To Tally’s surprise, Shay isn’t interested in the Pretty surgery.

Why Everyone Gets Their Pretty Surgery At Age 16 In Uglies

The Teenagers In Uglies Undergo A Major Transformation In Order To Become Adults

Netflix’s Uglies adaptation opens with Tally explaining how society became what it is, and by extension, why the government mandates cosmetic surgery when its denizens turn 16 years old. According to Tally, many years earlier, the world’s over-reliance on oil led to resource wars and societal collapse. Although the survivors tried to live peacefully — and even invented a sustainable and endless source of renewable energy — human nature got in the way. Despite their commonalities, humans couldn’t resist forming nations, factions, and communities predicated on their differences. To combat this, the Transformation was developed.

Allegedly, conformity breeds happiness and peace.

Much like the source material, the Uglies movie doesn’t give a clear-cut reason as to why people undergo their surgery at the age of 16, specifically. It seems like an arbitrary number, with the important factor being that the surgery occurs before the city’s residents become full-fledged adults. In many ways, the surgeries are treated as coming-of-age moments that usher the city’s youngest members into adulthood. On the surface, the government, helmed by Dr. Cable (Laverne Cox), wants everyone to get their surgeries so that there’s a sameness to them. Allegedly, conformity breeds happiness and peace.

How Uglies’ Transformation Works

Tally Creates Morphos To Fantasize About Her Post-Surgery Look

The Uglies movie doesn’t delve too deeply into the ins-and-outs of the Transformation, but it does portray just how much Uglies fixate on becoming Pretties. Tally frequently uses a program to make Morphos, a rendering of what she plans to look like post-surgery. In the book, the program doubles one half of the user’s face, creating a perfectly symmetrical visage. While the book’s version of the surgery suggests an absolute uniformity, the movie indicates that soon-to-be-Pretties have some control over their features. For example, Tally wants to select her hair and eye color.

What The Brain Lesions Do To People In Uglies’ Surgery

The Lesions Dull Pretties, Making Them Easier To Control

Midway through the film, Tally learns more about the Uglies’ surgery and the fact that it causes dangerous brain lesions in its subjects. After Shay runs away to join David and The Smoke, Cable tasks Tally with finding her friend, dangling Tally’s long-awaited surgery like a carrot. Although Tally doesn’t want to betray Shay, Peris and Cable convince Tally that she’s saving Shay and that David’s rebel group is constructing a weapon that will destroy the city and its way of life. Tally agrees to infiltrate David’s group, but what she discovers is much different from what Cable suggested.

The brain lesions make those who have undergone the Transformation unable to care or think.

Not only does The Smoke have a peaceful way of life, but its members reveal that the energy-harvesting orchid fields that power the city are actually leaching toxins into the earth and slowly killing the surrounding plant life. Tally is also shocked to learn that David was raised by his parents, Maddy (Charmin Lee) and Az (Jay DeVon Johnson), who were both state-employed cosmetic surgeons. While Maddy sat on the Morphological Standards Committee, Az dedicated his time to making the surgeries safer. In a twist, Az reveals that the surgery causes a pattern of brain lesions to form.

Maddy and Az go on to describe the lesions, noting that they form on the brain’s frontal cortex. Essentially, the brain lesions make those who have undergone the Transformation unable to care or think. Instead, they’re “sedated into a false sense of happiness.” In other words, by dulling the Pretties, and erasing their individuality, Dr. Cable hopes to control them.

The Side Effects & Changes From The Uglies Transformation Explained

Cable’s Desire To Control The Masses Is Why The Operations Really Happen

Given how she was raised, Tally is astonished to learn that the Transformation comes with incredibly damaging side effects and changes. In its earliest iterations, the operation resulted in several deaths a year. However, seizures and brain damage were not out of the question either. It seems like Cable’s current surgeries are somewhat less fatal; if people vanished, even Pretties might notice. Still, the brain lesions, which are the most disturbing fallout of all, aren’t even side effects. Since the lesions erase individuality and agency, and control is the true purpose of the surgery, the lesions are the whole point.

Uglies’ “Cure” Explained: How David’s Parents Plan To Heal The Transformation

The Serum Is The Best Weapon Against Dr. Cable’s Schemes

As seen in the Uglies‘ ending, not all hope is lost when it comes to curing the Transformation. Maddy and Az, who previously underwent the cosmetic surgery themselves, were actually purposefully given cures so that they could become thinkers again. This would allow them to perform surgery, and make them safer, instead of becoming Cable’s mindless soldiers. When they finally realized the dangers of Cable’s large-scale plan, Maddy and Az fled the city, establishing the community in The Smoke. An antithesis to Dr. Cable’s city, The Smoke is built on the principles of free thought and self-acceptance.

The cure heals the brain lesions, restoring victims’ sense of self, agency, and ability to think and feel.

Since receiving the cure themselves, Maddy and Az have spent 20 years trying to replicate the formula. In essence, the cure heals the brain lesions, restoring victims’ sense of self, agency, and ability to think and feel. Unfortunately, the cure isn’t complete. Az fears that testing it on humans could lead to seizures, permanent brain damage, and death. Maddy explains that they have the base serum but require a synthetic component, and that said nanosynth is readily available in the city. While that makes completing the cure challenging, the serum is the only weapon against Cable’s schemes in Uglies.