Aylmer has lived an efficient, but somewhat lonely life as a scientist with a keen interest in natural philosophy. Then one day he meets a beautiful woman named Georgiana whom he marries. Georgiana is not just your average, everyday beauty: she is nearly perfect. Almost flawless. It is that “nearly” and “almost” that is the problem. And that problem is a birthmark that takes the strange shape of a human hand which blemishes the left side of her face.
One day not too long after the wedding, Aylmer is studying her cheek when he inquires as to whether she has ever considered having the birthmark removed. To which she immediately replies in the form of reminding him that other men have found the blemish more charming than repulsive. To which Aylmer expertly points out that that, yes, upon a face of considerably less overall perfection such a mark might well add to the effect of beauty, but upon her face the exact opposite effect is produced and the birthmark serves only to point itself out as a singular case of imperfection.
Besides, the birthmark has the effect of being a shock to his system. A state of affairs which initially angers and then depresses Georgiana as she is forced to question whether Aylmer could really love her if a part of her has the power to shock him.
Aylmer disgust with the birthmark eventually turns into an obsession that he shares with his wife. He even begins to dream about and one night wakes up his wife with some very chilling words about cutting out her heart. Clearly Aylmer is heading in the wrong direction when it comes working out a happy marriage with a nearly perfect wife and while most wives at the point of husband dreaming about cutting into heart just to get rid of a birthmark on the face would flee, Georgiana does the exact opposite.
She decides to let Aylmer remove the birthmark. The first time she see the inside of the lab where he intends to experiment with processes for removal, Georgiana faints. At this, Aylmer’s assistant announces that if she were his wife, he’d leave the birthmark intact.
The process for relieving Georgian of the offensive blemish involves something akin to photography, alchemy, the Golden Principle, cosmetics and poison. One day she discovers a book which contains information previous experiments that her husband has conducted inside her bizarre laboratory. She begins to weep over the element of the book which contrasts the height of achievements of men with their failures and shortcomings. When caught, Aylmer warns of the danger that comes from reading the books of sorcerers and Georgiana only seals her fate by using the word worship to describe her love.
An argument over which of the two distrusts the other to the greater degree ensues before she requests a more detailed explanation of his plans for removing the birthmark. At this point, he is forced to confess that he has already tried out some potions on her without her knowledge, but obviously they have failed to do the trick. He has put great faith in one particular method of removal, but has delayed trying it since it is so dangerous. The creeping insanity that their shared obsession has become has pushed his poor wife to the point where anything is deemed preferable to the status quo.
Shortly afterward, Aylmer goes to his with a drug she is to drink. After doing so, she falls asleep and Aylmer watches, the birthmarks begins to fade until it is nearly gone. From behind, his assistant starts to quietly laugh and then Georgiana regains consciousness just long enough to inform her husband that she is dying but that he should not repent over his choosing to reject the best that earth had to offer. The assistant starts to laugh again.