Rourke portrays John Sedley AKA Johnny Handsome, a deformed man and a robber/planner who ends up in jail after being betrayed by two thieves who took part in the robbery that also saw his friend getting killed. Shortly after, he gets a facial reconstruction surgery that turs him into a normal-looking man with a new identity and a start in a new life. But John has one thing on his mind: revenge on the thieves who wronged him.
This film has examples of:
- Accent Relapse: After John is found out by Rafe and Sunny, the two criminals whom he's getting revenge upon, John relapses back to talking with a lisp that he had when he still sported a cleft on his upper lip.
- Best Served Cold: As John adjusts to his new identity, he plans his vengeance.
- Break Her Heart to Save Her: John does this with his love interest Donna McCarty so she doesn't get roped into his revenge scheme. She does anyway, but John manages to save her.
- Deep South: The film takes place in New Orleans.
- Downer Ending: John gets his revenge on Rafe and Sunny, but gets himself killed in the process. As bad as that ending was, it could've been worse, as even if he had survived, he would have still been sent back to jail by Drones, so either way, he would fail to live his new life.
- Even Evil Has Standards: While Sunny is willing to ditch Rafe should she find a better opportunity like she tried to do with John post-surgery, Rafe does at least seem willing to stick with her as he feels there's still a connection, though that doesn't stop him from puilling a gun on her when he thinks she's betrayed him.
- Faking the Dead: John Sedley's "death" was reported in the paper as he starts to live under his new identity.
- The Grotesque: John, before his surgery.
- Jerkass Has a Point: Lt. A.Z. Drones is on John's case, confident he would fall back to his old life style despite others having faith in him. Turns out he was right.
- No Honor Among Thieves: Rafe and Sunny, to the point where trust between the two of them remain suspect.
- Two First Names: For John Sedley's new identity, John Mitchell.