Plastic surgeon Robert Ledgard was successful in cultivating an artificial skin resistant to burns and insect bites, which he calls "Gal", that he says he has been testing on athymic mice.

He presents his results in a medical symposium but when he privately discloses he has also conducted illegal transgenic experiments on humans, he is forbidden to continue with his research.

While Ledgard is out, Marilia's estranged son Zeca, having committed a robbery, arrives in a tiger costume and asks his mother to hide him for a few days.

Zeca later left to live in the streets and smuggle drugs, while Ledgard went to medical school and married a woman named Gal.

Vera, too, dreams about the same event: Vicente, a young man who works in his mother's dress shop, crashes the wedding and meets Norma.

Vicente's mother reports his disappearance to the police, but after they find his motorbike at the bottom of a cliff, they tell her he is likely dead and has been swept out to sea.

During this period of time, Vicente struggles to keep himself sane and cling to the core of his true identity, seemingly drugged on opium by Ledgard.

Marilia, alerted by the sound of the shot, barges into the bedroom with her own pistol in hand and finds her son Ledgard dead on the bed.

Tearfully, he tells his lesbian ex-colleague Cristina (whom Vicente had loved six years prior) of his kidnapping, forced sex change, and the murders.

Almodóvar was inspired by Georges Franju's Eyes Without a Face and the thriller films of Fritz Lang when he wrote the screenplay.

[10] Due to developments in the industry of film distribution, El Deseo decided to abandon their previous release strategy for Almodóvar's works.

The site's summary reads "The Skin I Live In lacks Almodóvar's famously charged romance, replaced with a wonderfully bizarre and unpredictable detour into arthouse ick".

[14] Metacritic assigned the film a weighted average score of 70 out of 100, based on 37 critics, indicating "generally favorable reviews".

[15] In May 2011, Kirk Honeycutt, writing for The Hollywood Reporter, said "Along with such usual Almodóvar obsessions as betrayal, anxiety, loneliness, sexual identity, and death, the Spanish director has added a science-fiction element that verges on horror.

According to Gritten, "A list of the story's various elements— date rape, murder, secrets, lies, mystery parents, gender ambiguity, unbreakable emotional bonds—confirms The Skin I Live In as essentially a melodrama.

All three men have the gift of investing mundane objects with a unique sheen; here even surgical instruments, about to be used malevolently, assume a dreamy, otherworldly quality.

"[18] In an October 2011 New York Times Critics' Pick review, Manohla Dargis called the film "an existential mystery, a melodramatic thriller, a medical horror film or just a polymorphous extravaganza"; according to Dargis:[19] It takes time to get a handle on the story (and even then, your grip may not be secure), though it's instantly clear that something is jumping beneath the surface here, threatening to burst forth.

Vera's plight and the temporal shifts help create an air of unease and barely controlled chaos, an unsettling vibe that becomes spooky when Ledgard puts on a white lab coat and begins doing strange things with blood....There are times in The Skin I Live In when it feels as if the whole thing will fly into pieces, as complication is piled onto complication, and new characters and intrigues are introduced amid horror, melodrama and slapstick.... [Yet] Mr. Almodóvar's control remains virtuosic and the film hangs together completely, secured by Vera and Ledgard and a relationship that's a Pandora's box from which identity, gender, sex and desire spring.Dana Stevens noted it was Almodóvar's "first attempt to blend elements of the horror genre with the high-camp, gender-bending melodrama that's become his stock in trade"; she called it "visually lush and thematically ambitious", a film that "unfolds with a clinical chill we're unaccustomed to feeling in this director's films.

Stevens called it a "meditation on profound themes: memory, grief, violence, degradation, and survival", a "multigenerational melodrama [that] slowly fuse[s] into a coherent (if wackily improbable) whole", offering "aesthetic and intellectual gratification, but little in the way of emotional punch.