Alicia Silverstone, James Franco and Selma Blair play three characters who are the focus of various Hollywood films about the lives of children with deformities. In order to give a sense of authenticity to this film, producer Larry Franco visited hospitals and clinics around the world to create a realistic representation for these young people. This includes casting patients from the American Society for Surgery of Children at University Children's Hospital in Leiden, Netherlands as Max and Anne-Marie. The two also contributed their own ideas and thoughts to the script through extensive interviews with doctors, social workers and other experts on these topics. Dr. Stephen Scott, medical director at the ISPCAN visited the set during filming. Similarly, the depiction of the facial disfigurement of two of these three characters has been publicly questioned by some individuals who are concerned that this may stigmatize others. The film producers have responded that they are not making a documentary or educational film about medical treatment, but rather an "exploration into human relationships and how we react to difference". The story is told in a non-linear fashion and begins with Mia's story about her life and her lover and husband Dean. We then flash back to Max and his mother Anne-Marie's life when he was just a boy and they lived in the suburbs where he was born. Max is different from his peers, but unaware of the cause. His parents are concerned by this, especially since he has a twin brother who is not affected by it. However, they are also protective and supportive of him and his brother. Anne-Marie blames herself for passing on a genetic disease to her children and we see she was adopted as an infant and so the biological father of the twins may not be her husband. Max visits a special school where he meets Lee and Alicia, who will become his lifelong friend. He also meets Caroline there who will become his girlfriend later on in life. Max's brother is killed in a freak accident after the boys are given a BB gun by their father. Anne-Marie meets her biological mother for the first time, who lives alone in the woods, and she tells Anne-Marie that she was born with a genetic disease in which her face would shortly begin to disintegrate in front of her eyes. She is not sure what triggered her disease in Anne-Marie, but has since had surgery to prevent it from occurring to any of her other children. Ironically, this is likely the reason why Max was born without facial disfigurement and because of this, his disease wasn't apparent at first and he didn't need surgery like his mother did. Max's parents and Anne-Marie end up leaving their house on a lark, and they end up at the home of Dean and Mia on a stormy night. Later, Anne-Marie and Max visit a carnival where they meet Lee and Alicia, who recognize him as the brother of their friend Max. They ask him to join them on their road trip to see the monster ball show in New York City as Mia does not want to travel alone as she is afraid of the dark. Lee and Alicia turn out to be very attractive girls with money and class, but they aren't right for Max due to him being too young for them even though he still wants to be friends with them.
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