And again, this isn't mere vanity; people suffering from body dysmorphia disorder look in the mirror and often see a distorted, even grotesque, image in their reflection.
There are people who have deformities or other sorts of visible physical afflictions, burns, that sort of thing, where plastic surgery could truly change their lives for the better.
This could perhaps refer to someone in the circus a long time ago when they still had " freak shows, " in which people would pay to look at people with physical abnormalities, either real or fake.
" She came to court with Jenny of Oldstones. A stunted thing, grotesque to look upon. A dwarf, most people said, though dear to Lady Jenny, who always claimed that she was one of the children of the forest" .