An Italian surgeon, Timoteo, is shocked when his teenage daughter, Angela, is brought to his hospital with a severe head injury after a motobike accident. While other doctors struggle to save her he finds himself thinking of a torrid, violent but ultimately passionate affair that nearly wrecked his marriage and his career just before Angela was born.
When his car broke down on the edge of the city Timoteo asked Italia (Penélope Cruz) to use her phone. In her shabby home surrounded by half-built appartments he responded to her kindness and his own unhappiness by raping her.
He became obsessed with the almost destitute, poorly-educated peasant woman who the antithesis of his glamorous, sophisticated, and succesful wife Elsa. Italia, a victim all her life, caved in to his demands and they began a relationship which gradually moved from the physical to the emotional and only ended with her death during an abortion.
Maurizio Silvi was the key makeup artist; Whitney James was the personal makeup artist for Penélope Cruz; Luigi Rocchetti was the special effects makeup artist; Mauro Tamagnini was the hairstylist.
Penélope Cruz, stopped shaving her legs for an authentic look, and talked about the transformation she underwent for the role:
The character needed that. I mean, that woman has never been to the doctor or the dentist. [She] does her own hair. She has this image of herself and I think that she makes herself look even more ugly because of her own [lack of] self-esteem … We did it [the look] together. Me and [Whitney James], the makeup artist and Sergio and his wife who wrote the book. There are four pages in the book that talk about the way she looks and why she looks like that, and her clothes.