In a futuristic society where aesthetics dictate status, 16-year-old Tally Youngblood is poised to undergo a transformative surgery that will elevate her from an 'Ugly' to a 'Pretty'. This coveted operation promises access to a utopian playground reserved for the beautiful. But her excitement is dampened when her friend Shay chooses to forgo the procedure, escaping to join a rebellious group called the Smokies. Faced with a terrible ultimatum by the authorities—to betray Shay’s freedom or never become 'Pretty'—Tally's decision leads her into a tumultuous journey that exposes the grim realities veiled by superficial beauty and challenges the very essence of her identity.