Whether present at birth, congenital or acquired later in life, a visible disfigurement can have a profound psychological impact upon the individual concerned. Difficulties include adverse effects on body image, quality of life, and self-esteem. In addition, social encounters can present many challenges, however many individuals adapt to the demands placed upon them and appear relatively unaffected by their visible difference. This article reviews current literature exploring the psychosocial implications of living with a visible difference and considers the complex influence of physical, cultural, and psychosocial factors on adjustment. Attempts that have been made to theorise individual's experiences, relevant interventions and care provision are then examined and the challenges facing researchers in this area are outlined.