Altman is writing about losing face in the most literal sense of the term: not just becoming unrecognizable, but becoming deformed.
During a visit to the dentist, Altman had a bad reaction to the anesthetic. Unaware of her altered appearance she went to buy some cosmetics. There, she discovered the truth: "... I leaned in close to the mirror. Wait a minute. My top lip was as big as my palm and hung down like a purple piece of liver."
In ensuing paragraphs Altman describes the reaction of people she encounters at random during the day. They were nothing you would wish for.
Note that Altman's problem has nothing to do with beauty, and everything to do with no longer being recognizable as a member of a human community.
In the end she assesses her experience and draws a startling conclusion: "Maybe how you look defines your entire being. Maybe there is no such thing as 'self' esteem or 'inner' resources. Maybe our idea of ourselves comes from the countless mirrors that reflect us in the eyes of others. Maybe it's not what's inside that counts."
Having offered a similar thought in my book on "Saving Face" I find Altman's conclusion to be excellent.
After all, coaching is an outside/in line of work. It is good to read a confirmation that we may have gotten the direction right.