Elisabeth Sparkle is the main protagonist of The Substance, with her substance-clone, Sue, serving as the film's main antagonist.
She is one of the most desired and successful actresses of Hollywood back in her younger years. However, age is rapidly diminishing her and status, so she’s clearly had a long career she’s proud of. But she’s forced to brutally confront her approach to its inevitable end when she overhears her sleazy executive producer, Harvey, scheming to replace her.
Biography[]
On her fiftieth birthday, Elisabeth was abruptly dismissed from her long-running aerobics TV show by the producer, Harvey, due to her age. A distraught Elisabeth crashes her car while distracted by a billboard of herself being taken down. At the hospital, a young nurse covertly gives her a flash drive advertising "The Substance", a black market serum that promises a "younger, more beautiful, more perfect" version of oneself.
Elisabeth, intrigued and desperate, orders The Substance and injects the single-use activator serum. She convulses as her body generates a younger version of herself, who emerges from a slit in her back. The two bodies must switch consciousness every seven days without exception, with the inactive body remaining unconscious and fed intravenously with a weekly food supply. Daily injections of stabilizer fluid, extracted from the original body, are required to prevent the new body from deteriorating.
The new body, who names herself Sue, becomes an overnight sensation after auditioning to be Elisabeth's replacement and is eventually offered the chance by Harvey to host the network's prestigious New Year's Eve show. While Sue lives a confident and hedonistic life, Elisabeth becomes a self-hating recluse. Nearing the end of one weekly cycle, Sue parties and brings a man home for casual sex, delaying the switch by extracting additional stabilizer fluid, causing Elisabeth's right index finger to rapidly age. Elisabeth contacts the supplier, who warns her that disobeying the switching program will lead to irreversible, rapid aging of the original body. Despite their shared consciousness, Elisabeth and Sue begin to view themselves as separate individuals and grow to despise each other; Elisabeth resents Sue for her frequent disregard of the switching schedule, which further exacerbates her aging, while Sue is appalled by Elisabeth's self-loathing and binge-eating. Following a particularly destructive episode as Elisabeth, Sue stockpiles on stabilizer fluid and refuses to switch back.
First Death[]

Elisabeth's death.
Three months later, on the day before the New Year's Eve telecast, Sue runs out of stabilizer fluid and contacts the supplier, who informs her that she must switch back to replenish the fluid. When they switch, Elisabeth finds herself transformed into an elderly hunchback. Desperate to stop Sue from aging her further, Elisabeth orders a serum designed to terminate her. However, Elisabeth, still craving the admiration that Sue's celebrity status provides, stops before fully injecting the serum and resuscitates Sue, leaving both of them conscious. Realizing Elisabeth's initial intent to terminate her, Sue attacks her, repeatably bashing Elisabeth's face with the bathroom mirror before stomping her to death.
Sue's Mutation[]
Despite killing Elisabeth and seemingly earning her place as host of the New Years Eve program, Sue's body begins to decay due to the termination fluid injected beforehand. It begins when a couple of her front teeth fall out, which progresses to her fingernails and even an ear. In desperation to retain her younger form, Sue realizes the expired activation solution could give her a new and possibly even better form of herself. She rushes back home and takes the fluid, ignoring its single use warning, begging for the best version of herself to come out.
As she wakes up, the solution has indeed worked, but not to the desired affect. Instead, what has come out of Sue's back is an eldritch abomination made of various body parts and a seemingly linked consciousness between Elisabeth and Sue: Monstro Elisasue. This new being, still in part under the influence of Sue's consciousness, still decides to go to the New Years Eve program. It puts on Sue's gown, tearing it heavily in the process, and makes herself "presentable" by putting on Sue's earrings and necklace, and using a curling iron on what little hair she has. Elisasue then breaks open a large poster of Elisabeth that has been hanging on her wall throughout the film and cuts out the face in it. She then glues it to her face, and putting lipstick on it, races back to the studio to host the New Year's TV program.
Final Death[]

"Monstro Elisasue"'s death.

Elisause's face melting.

During the show, Elisasue's mask falls off exposing her mutation to the audience, causing them to erupt into chaos. An audience member decapitates her, only for an even more mutated head to grow back, and one of her arms to break and drench both the audience and studio in blood. Elisasue flees the studio, but collapses and explodes into viscera. Elisabeth's original face detaches from the gore, crawling onto her neglected star on the Hollywood Walk of Fame. She smiles as she hallucinates being admired before melting into a puddle of blood, which is cleaned up by a floor scrubber the next day.
James gave the death of Monstro Elisasue's main body the Golden Chainsaw because it was cathartic after all the abuse Elisabeth's body went through during the film.