A serial killer is targeting the women of Miers, Colorado, and so far the police have nothing to go on. Detective Casey O'Toole is assigned to jump-start the investigation, and she discovers two unsettling facts: the victims were all patients of a prominent plastic surgeon, and each of them bears an uncanny resemblance to herself.

Ruled out as a suspect, Dr. Mark Adams offers to assist Casey in any way he can and, despite her resistance, their relationship quickly turns personal. The pressure on Casey to find the killer mounts steadily as terror grips the small mountain community. Then a stunning twist leads Casey to the deadly truth -- and to the face of a killer nearly as familiar as her own.