[1] The novel is set in a future dystopian world in which everyone is turned "Pretty" by extreme cosmetic surgery upon reaching age 16.

It tells the story of teenager, Tally Youngblood, who finds that life as a partygoing "Pretty" is not as attractive as she thought.

Real Specials arrive and so he leaves and Tally tries to follow him by jumping off a balcony with Peris, who is wearing a bungee jacket.

They bounce, but Tally is hit in the head hard enough to make her bleed and is voted into the Crims because of her "bubbly" stunt.

They face strenuous, dangerous physical challenges to locate the item, which is accompanied by a letter from Tally to herself, written before she was turned pretty.

One day, the Crims pull a bubbly trick by using alcohol to melt a hovering ice rink and crash a soccer game, which causes the clique to become famous.

While in Uglyville, they find out that Shay has started a clique with Crim rejects, the Cutters in which they cut themselves to cure the lesions.

Through their travels, Tally comes to deduce that the villagers are living in a forcefield-protected reservation in which Specials and Pretty Scientists conduct experiments about violence and ways to reduce mankind's violent nature.

Perhaps the Pretty operation that clouds everyone's minds is the only way that humans can live in peace without destroying each other or the planet.

A review in Horn Book Magazine said that while Pretties "suffers from some typical middle-book problems" as the second installment in a trilogy, "the world Westerfeld creates is both appealing and appalling; the pace moves quickly with twists; and Tally is a memorable, believable character".