The most grounded and emotionally realistic scene in The Substance also serves a dramatic purpose as a subtle microcosm of the entire movie. From the twisted mind of writer-director Coralie Fargeat, The Substance is a body horror masterpiece that uses a fictional beauty-enhancing drug as a satirical stand-in for all the dangerous cosmetic procedures that people undergo to cling to their youth. As she starts losing work past the age of 50, fading celebrity Elisabeth Sparkle begins taking this drug to improve her appearance (and it quickly gets way out of hand).