The central conflict in this story is Aylmer's fight against all that is natural. He is a failed scientist who is constantly attempting to "improve" and "fix" all that surrounds him. His lab is full of failed experiments, and his struggle to succeed is a source of pain and anguish for him.
He is married to the beautiful Georgiana. Her birthmark, in the shape of tiny hand on her cheek, is a source of disgust for him. As usual, he feels he should "fix" her by removing the mark by scientific means. It does not matter to him that she has always had this birthmark, and that Georgiana and those who know and love her see it as a blessing--the mark of angels or God Himself on her sweet face. It is part of who she is and part of her beauty. He looks at her, however, with such disgust that she eventually begs him to remove it regardless of the consequences. Ultimately, he is succssful, but Georgiana dies in the process.