Right up there with vampires and zombies, the mad scientist using his surgical skills to try to revive, restore or otherwise recreate the wife that was taken from him in the bloom of youth and beauty is one of the staples of the horror film. I don’t know which was the first version of the tale—surely something starring Boris Karloff or Bela Lugosi, both of whom played any number of doctors obsessed with unorthodox methods to unachievable goals? But the apotheosis of it was surely Georges Franju’s 1960 Eyes Without a Face, that most poetic film that cinema snobs hate to label a horror movie.

Pedro Almodovar has never met a film from the 1950s that he doesn’t adore, so his take on this story was probably inevitable. What is surprising is how icily elegant his adaptation is, with far less humor than his fans expect from his work.

Originally titled La piel que habito (the English title may be the most accurate translation but feels clumsy), The Skin I Live In casts as its unhinged surgeon Antonio Banderas, who as a youth co-starred in Almodovar’s 1986 horror tribute Matador. Just past 50, he’s perfect for the part, reminding us of the younger Lugosi before his career was derailed by too many third-rate films.

Banderas is Dr. Ledgard (even the character sounds like one from Lugosi’s CV), a plastic surgeon who has developed an artificial skin that is resistant to insects as well as to burns. Presenting this to his colleagues, he gets the standard response (“You’re insane!”) and is sent packing to his private clinic.

Here he watches Vera (Elena Anaya), his patient, though “prisoner” is the more appropriate term, a beautiful young woman who lives in comfort, practices yoga, and writes endlessly on the white wall of her cell. We are not surprised to learn that she is the image of Ledgard’s wife, who died after being horribly burned in a car accident. But there is much afterwards that does surprise us: The clichéd horror movie scenario Almodovar has established is a jumping-off place for a film in which every scene seems designed to force us to reinterpret the one that came before it.

This structure does have the effect of draining away the sympathies we develop early on: It ends at a place different from where we began, to an effect that’s hard to interpret. If you’re an Almodovar fan for his loveably colorful, humanistically depicted characters, this film may not be to your liking. But for film geeks who enjoy playing “Name That Reference” and get off on sheer craft, you won’t go away unhappy.

Watch the trailer for The Skin I Live In