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Vicissitude is the signature power of the Tzimisce, and is rarely shared outside the Clan (though it is known to some other Cainites of the Sabbat). Similar to Protean in some ways, Vicissitude allows vampires to shape and sculpt flesh and bone. When a Kindred uses Vicissitude to alter mortals, ghouls, and vampires of higher Generation, the effects of the power are permanent; vampires of equal or lower Generation can choose to heal the effects of Vicissitude as though they were aggravated wounds. A wielder of Vicissitude can always reshape her own flesh.

The wielder must establish skin-to-skin contact and must often manually sculpt the desired result for these powers to take effect. This also applies to the use of the power on oneself. Tzimisce skilled in Vicissitude are often inhumanly beautiful; those less skilled are simply inhuman.

There are rumors that Vicissitude is a disease rather than a “normal” Discipline, but only the Fiends know for sure, and they aren’t talking.

Note: Nosferatu always “heal” Vicissitude alterations, at least the ones that make them better-looking. The ancient curse of the Clan may not be circumvented through Vicissitude. The same applies to physical deformities from the Gangrel Clan weakness.

A vampire with this power may alter her own bodily parameters: height, build, voice, facial features, and skin tone, among other things. Such changes are cosmetic and minor in scope — no more than a foot (30 cm) of height gained or lost, for example. She must physically mold the alteration, literally shaping her flesh into the desired result. The player must spend a blood point for each body part to be changed, then roll Intelligence + Medicine (difficulty 6). To duplicate another person or voice requires a Perception + Medicine roll (difficulty 8), and five successes are required for a flawless copy; fewer successes leave minute (or not-so-minute) flaws. Increasing one’s Appearance Trait has a difficulty of 9, and the vampire must spend an additional blood point for each dot of Appearance increased beyond their natural total. A botch permanently reduces the Attribute by one.

Note: Any additional Appearance dots gained this way must be bought with experience, or they will revert come dawn.

This power is similar to Malleable Visage, above, but allows the vampire to perform drastic, grotesque alterations on other creatures. Tzimisce often use this power to transform their servitors into monstrous guards, the better to frighten foes. Only flesh (skin, muscle, fat, and cartilage, but not bone) may be transformed. After spending a blood point, the vampire must grapple the intended victim. The player of the Flescrafting vampire makes a successful Dexterity + Medicine roll (difficulty variable: 5 for a crude yank-and-tuck, up to 9 for precise transformations). A vampire who wishes to increase another’s Appearance Trait does so as described under Malleable Visage; reducing the Attribute is considerably easier (difficulty 5), though truly inspired disfigurement may dictate a higher difficulty. In either case, each success increases or reduces the Attribute by one.

A vampire may use this power to move clumps of skin, fat, and muscle tissue, thus providing additional padding where needed. For each success scored on a Dexterity + Medicine roll (difficulty 8), the vampire may increase the subject’s soak dice pool by one, at the expense of either a point of Strength or a health level (vampire’s choice).

This terrible power allows a vampire to manipulate bone in the same manner that flesh is shaped. In conjunction with Fleshcraft, above, this power enables a Vicissitude practitioner to deform a victim (or herself) beyond recognition. This power should be used in conjunction with the flesh-shaping arts, unless the vampire wants to inflict injury on the victim (see below). The vampire’s player must spend a blood point and make a Strength + Medicine roll (difficulties as above). Bonecraft may be used without the fleshshaping arts, as an offensive weapon. Each success scored on the Strength + Medicine roll (difficulty 7) inflicts one health level of lethal damage on the victim, as his bones rip, puncture, and slice their way out of his skin.

The vampire may utilize this power (on herself or others) to form spikes or talons of bone, either on the knuckles as an offensive weapon or all over the body as defensive “quills.” If bone spikes are used, the vampire or victim takes one health level of lethal damage (the vampire’s comes from having the very sharp bone pierce through his skin — this weaponry doesn’t come cheaply). In the case of quills, the subject takes a number of health levels equal to five minus the number of successes (a botch kills the subject or sends the vampire into torpor). These health levels may be healed normally. Knuckle spikes inflict Strength +1 lethal damage. Defensive quills inflict a hand-to-hand attacker’s Strength in lethal damage unless the attacker scores three or more successes on the attack roll (in which case the attacker takes no damage); the defender still takes damage normally. Quills also enable the vampire or altered subject to add two to all damage inflicted via holds, clinches, or tackles.

A vampire who scores five or more successes on the Strength + Medicine roll may cause a rival vampire’s rib cage to curve inward and pierce the heart. While this does not send a vampire into torpor, it does cause the affected vampire to lose half his blood points, as the seat of his vitae ruptures in a shower of gore.

Kindred use this power to become hideous and deadly monsters. The vampire’s stature increases to a full eight feet (two and a half meters), the skin becomes a sickly greenish-gray or grayish-black chitin, the arms become apelike and ropy with ragged black nails, and the face warps into something out of a nightmare. A row of spines sprouts from the vertebrae, and the external carapace exudes a foul-smelling grease. The Horrid Form costs two blood points to awaken. All Physical Attributes increase by three, but all Social Attributes drop to zero, except when dealing with others also in Horrid Form. However, a vampire in Horrid Form who is trying to intimidate someone may substitute Strength for a Social Attribute. Damage inflicted in brawling combat increases by one due to the jagged ridges and bony knobs creasing the creature’s hands. A vampire with this power can physically transform all or part of her body into sentient vitae. This blood is in all respects identical to the vampire’s normal vitae; she can use it to nourish herself or others, create ghouls, or establish blood bonds. If all this blood is imbibed or otherwise destroyed, the vampire meets Final Death. The vampire may transform all or part of herself as she deems fit. Each leg can turn into two blood points worth of vitae, as can the torso; each arm, the head, and the abdomen convert to one blood point each. The blood can be reconverted to the body part, provided it is in contact with the vampire. If the blood has been utilized or destroyed, the vampire must spend a number of blood points equal to what was originally created to regrow the missing body part.

A vampire entirely in this form may not be staked, cut, bludgeoned, or pierced, but can be burned or exposed to the sun. The vampire may ooze along, drip up walls, and flow through the narrowest cracks, as though she were in Tenebrous Form (p. 190).

Mental Disciplines may be used, provided no eye contact or vocal utterance is necessary, although the vampire can perceive her surroundings just fine (but the perceptions are always centered on the largest pool of blood). If a vampire in this form “washes” over a mortal or animal, that mortal must make a Courage roll (difficulty 8) or fly into a panic.

Similar to Horrid Form, the Chiropteran Marauder is a terrifying, bipedal bat, bearing a wickedly fanged maw and veined, leathery wings. This power confers all of the benefits of the Horrid Form, in addition to a few others. The mere sight of the marauder is enough to make mortals or weak-willed vampires flee in horror. The vampire gains all the effects of the Horrid Form. Further, the Marauder’s fluted wings allow flight at 25 mph (40 kph), during which the vampire may carry, but not manipulate, objects no larger than it can hold in its hands. If the player chooses to, she may make a Strength + Medicine roll (difficulty 6) to extend bony claws at the ends of the vampire’s wings. These claws inflict Strength +2 aggravated damage. Also, the vampire subtracts two from all hearing-based Perception rolls (though he adds one to vision- based Wits and Perception rolls). Assuming the mantle of the Chiropteran Marauder costs three blood points. At this level of mastery, the vampire has converted his blood to a viscous acid. Any blood he consumes likewise becomes acid, which is corrosive enough to burn human (and vampiric flesh) as well as wood. This effect is particularly potent when the vampire assumes the Bloodform. One of the side effects of this power is the complete inability to create new vampires and ghouls, or give blood to another vampire — the acid would corrode them as they drank it. The obvious benefit, however, is that would-be diablerists are likewise unable to devour the Cainite’s blood. Each acidified blood point that comes in contact with something other than the vampire himself does five dice worth of aggravated damage. If the vampire is injured in combat, his blood may spatter on an opponent — foes must make Dexterity + Athletics rolls to avoid the blood, which must be accomplished by splitting their dice pools. (Unless an opponent knows the vampire has this power, she’s unlikely to split her dice pool on her first attack, which causes many Tzimisce to cackle with glee.) Pain is transformative. Pain awakens primal potential in the tortured flesh. A Fiend with this ability delights in every slash of the blade and caress of bullet, transmogrifying agony into physical prowess and incredible displays of Caine’s Gifts. After spending two Willpower points, the character becomes empowered by pain. Add his wound penalties to all non-reflexive actions involving a Physical Attribute or use of a Discipline. As the character heals, this bonus wanes. Treat Incapacitated and Final Death normally. This power lasts for one scene. With normal Vicissitude, a Tzimisce may take the arm from one person and graft it to another, but the recipient is unable to control the arm and it soon begins to decay. With this power, the user may take body parts from living creatures and graft them on to others, living or undead, and allow for the recipient to use the new limb. Exceptionally monstrous and disturbing creatures can be created with this power or one may graft extra organs into others, allowing them to function longer while wounded. Removing a limb requires an Intelligence + Medicine roll (difficulty 6). Extracting an organ is an extended Intelligence + Medicine roll (difficulty 7), with 10 successes required and each roll representing an hour of work. The process of grafting must then begin within an hour. or the limb or organ dies. Attachment is an extended roll of Intelligence + Medicine (difficulty 7), requiring 10 successes and each roll representing half an hour's work. Attaching an appropriate limb, such as a human arm to a human, is difficulty 7. Attaching an inappropriate limb, such as horse legs to a human, is difficulty 8. Inserting organs is difficulty 9. Attaching limbs to a vampire is somewhat easier (difficulty 6). Theoretically, one could put organs inside a vampire, but this has no effect.

The effect of attaching extra limbs is entirely up to the Storyteller. Extra arms might help in grappling and multiple attacks and extra legs might aid stability but the main effect is generally freakishness rather than effectiveness, since coordinating the extra limbs is very difficult. Extra organs grant the recipient an additional wounded health level per organ, though a maximum of two can be grafted.

The Fiend’s face erupts into a mass of tentacles, a foot in length and similar to that of a squid. These tentacles can be used to grasp and constrict a foe. Moreover, in place of a squid’s suckers are rows and rows of fanged, drooling mouths, permitting incredibly rapid blood drain. The vampire spends a Willpower point and rolls Stamina + Medicine (difficulty 8). Success enables formation of the tentacles with no loss of sensory abilities. The tentacle mass can be used in melee (difficulty 5; Strength +2 lethal damage). A successful hit indicates a grab. Feeding begins on the same turn as the initial grab, and for each success scored on the attack roll, one additional blood point can be drained from the victim each turn, as dozens of mouths bite and suck. To break the grip, the victim must score three more successes than the vampire in an extended contest of Strength. Victims of this gruesome power are betrayed by their own bodies, as the Tzimisce transforms his opponents' flesh and bone into pools of blood. Vampires under the influence of this ability retain their sentience, but may lose their sanity. if the power affects a mortal, the subject dies. The blood can nourish a vampire or be used to create ghouls or stablish Blood Oaths (the latter two uses function only if the liquefied victim was a vampire). Vampires who imbibe all the vitae of a transmuted Cainite are assumed to have diablerized the victim. To transform another creature, the vampire must touch her target; flesh-to-flesh contact is mandatory. The player spends a Willpower point and rolls Stamina + Medicine (difficulty 8). Each success turns a portion of the victim's body into a Blood Point's worth of vitae. The target can negate the Tzimisce's successes by rolling Stamina (difficulty 8). Each success turns a portion of the victim's body into a Blood Point's worth of vitae. The target can negate the Tzimisce's successes by rolling Stamina (difficulty 6). Each success on the Stamina roll reduces the Tzimisce's successes by one.

The torso and each leg is worth two Blood Points, while the head, abdomen and arms are each worth one. If an entire portion of the target’s body undergoes the transformation, that body part turns into a pool of blood and is useless (assuming the subject survives). Attacks to the head, abdomen or torso kill mortals outright. Vampires survive such attacks, however, even if their heads separate from their torsos. Vampires can re-form lost body parts by expending a Blood Point for each one that is transmuted (one for the head, two for a leg, for example).

Vampires transformed entirely into blood retain consciousness. Barring skill in Vicissitude, however, they retain no powers of locomotion or any other abilities. A vampire in this form cannot be staked, cut, bludgeoned or pierced, though fire and sunlight have the usual effect.

Some powerful Tzimisce use this power to mark the edges of their demesnes. To activate this power, the Fiend must grasp a victim, holding them for a full turn. The victim's spinal cord springs through the crown of his skull and his anus, generally causing the victim's death. Furthermore, the rigid spine-shaft uncoils to a length of 10 feet and (if the victim stands on soil, earth or other soft material) affixes the victim to the ground, thereby forming a "stake" or "signpost" of sorts. The vampire grasps her victim and rolls Strength + Medicine (difficulty 8). If the vampire succeeds, the victim takes (10-Stamina) health Levels of damage. Furthermore, the victim is considered horribly encumbered (minus three to Dexterity).

It can be assumed that mortals who suffer this self-impalement die shortly even if the initial damage does not kill them.