When Pedro Almodovar's Volver premiered at the Toronto International Film Festival in 2006, the hot topic was how Penelope Cruz's ass was not Penelope Cruz's ass. Almodovar, the Spanish director as famously fascinated by the female form as he is openly gay, had decided that Cruz's posterior wasn't prominent enough for a blue-collar mom, so he fashioned her a prosthetic backside. Even odder? She said she had grown, well, attached to it. 

“I didn’t want to take my false ass off,” Cruz told a press conference. “I was a disaster for two months.” 

These very particular body-image issues are at the core of The Skin I Live In, Almodovar's violently outre new movie. It proves that the director's penchant for physical modification has only grown more pointed—or rounded. It is perhaps the most twisted and unsettling film Almodovar has made (and this is a director whose Talk to Her featured a nurse tenderly raping his comatose patient), but it is not exactly a horror movie. Instead, it is a throwback to golden-age Hollywood's mad-scientist movies, as if the dress-up games of Vertigo had been conducted by James Whale around the time he made Bride of Frankenstein.

The mad scientist, a plastic surgeon to be exact, is played by Antonio Banderas, and he is most certainly insane. Other characters keep mentioning this to him, in case he had forgotten. His mother (Marisa Paredes, an expert at widening her eyes to indicate horrible memories) is especially distraught. "It's my fault," she says. "I've got insanity in my entrails." Banderas has a laboratory filled with stacks of petri dishes, vials of blood and tanks crawling with woodlice. In a locked room of his country estate, he is keeping a gorgeous test subject played by Elena Anaya; she is modeling his innovative, bug-resistant artificial skin, and she may hide a few other nips and tucks they're not discussing. She seems relatively serene, though she is taking a lot of opiates. Then a disfigured bank robber dressed in a tiger suit arrives at the door, and starts licking the security cameras.

Here I'd better stop the synopsis, because I'm getting dangerously close to spoiling the movie (and upsetting voters in David Wu's congressional district). But I can say that the tiger suit is explained by Carnival season—and this is important, especially when you consider that the term "Carnival" may originate from the phrase "farewell to meat" or "farewell to the flesh." The Skin I Live In is a movie where flesh is endlessly dispensable and malleable, but also one that pulls you into the consciousness of a man who sees all corporal desire as grotesque perversion. There's a great scene midway through the picture where Banderas stumbles upon a teenage hook-up party: As he watches from the bushes, couplings and threesomes look like a tableau from the corner of Bosch's painting The Garden of Earthly Delights.

The absurdity is held together by Banderas, whose understated performance recalls the pained dignity of James Mason in Lolita. Likewise, the movie proceeds calmly, through elision and implication, until it becomes a study of how sexuality can be formed through victimization—people shaped against their will—yet leaving room for a sense of self to emerge triumphant. In the background of one scene, Chris Garneau sings a cover of Elliott Smith's "Between the Bars," with its verse, "People you've been before/ That you don't want around anymore." With The Skin I Live In, those old identities are removed with extra padding. Almodovar takes the elements of classic films—the doctor playing God, the grand staircase, the femme fatale—and splices them into unexpected shapes that turn out to be exactly what you wanted. 

86 SEE IT: The Skin I Live In is rated R. It opens Friday at Fox Tower.