A nightmare and an idea

[Augustus]

Are you sure you're ok with this procedure? It might very well drive you insane.

Yes, it is for the best.

At this point my view became clear and I could see the sterile landscape of a surgery room. A woman was lying on the cold steel table which design lent it more towards the dissection of the dead than the preservation of the living.
A chirgeon was standing beside the patient wearing the ambiguous masks that hide all but the eyes which at this time were arrayed at the barbarous tools set before him.

If it's alright with you, I'd like to begin. I will wake you when I am done.

Darkness sets in as the patient passes into the land of dreams...

There, the procedure is complete. You may sit up, but avoid mirrors and reflective surfaces for a while until your psyche adjusts to the...changes.

I WANT TO SEE! GIVE ME THAT!
The patient grabs a nearby mirror and instead of his face he is instead greeted by the eternal grin of a bare skull which retorts with a visceral keen which it,..he, shouldn't be able to make anymore.
Please, Please you will get used to it. NO STOPPPPPPPP!!!
*At this point my view backed up and I could see the flensed and metallicised skeleton arise and slam the chirgeon onto the table and force a nerby drill through the front of his face.*

This nightmare gave me an idea for a new monster. I'm not sure what to call it but it is an organic life form that has been flensed alive but has been kept alive through a combination of curative, necromantic magics and metallic augmentation. The process leaves its victims thoroughly insane. I see these guys as having a sound based attack that could possibly deafen someone for a few minutes and maybe some construct immunities. Bah I don't know post your input bout this if you feel like it. If not oh well:)

[ScS of the Fraternity]

Definitly sounds like a unique villanous character, rather than a series of monsters.
Pleanty of things a skull faced mad man could get up to.

If you were set on having monsters rather than unique NPCs, you could create a breed of creatures caused by an addiction to surgery. Just as in modern day, there are people who are addicted to body modification and surgery.
Though normally isolated, a large number have gathered to form a secret society dedicated to the "perfection" of the human body by removing everything unnecessary. This includes loping off fingers, noses, replacing eye lids with glass lenses, stiching leather into their skin, ect... In addition, the cultists add on to their bodies with extra tendons and bone grafts. Even their skulls are modified to drain out the toxins that necessitate sleep.
The result is an emaciated, freakish alien - inhumanly fast, strong and tough.

These malformed mutants remove most of their organs, making them peternaturally tough and resiliant to damage. Inside their body cavities are metal tanks, which hold a disgusting mixture of blood, bile, pus (for white blood cells) and other organic fluids to keep them alive without the need for their own organs.
These fluids are retrived from 'The Farm", a nightmarish prison where human beings are used like cattle to produce the vital fludis and spare parts needed for the girsly proceedures.

[Augustus]

My god that's good. What domains do you see such a society in? I'm thinking either Dementlieu or Lamordia. You'd expect that sort of evil from one of the elder abberation races ,but a group of humans.. ghastly.

[ScS of the Fraternity]

Sounds like soemthing that would be based in Dementlieu, where there would be a large number of riddiculously wealthy, but mentally disturbed nobles.
The org. could have started out in Lamordia, however, at the behest of a mad surgeon.

The cabal might be based inside of hospital or a medical college, with an extensive network of tunnels beneath it. Somewhere in these tunnels is The Farm, and the colony of the abberant humans. Above ground, the Mad Surgeon plies his mundane trade, and applies for grants and performs special procedures to fund his research. From time to time, some of his patients might disapear - having been dragged off to the Farm.

[Rotipher of the FoS]

How about if one of the cerebral vampires from Dominia were involved in this...? It sounds like something that one of their number might well start up, as a twisted experiment in the psychology of surgical addiction.

[ScS of the Fraternity]

That's nto a bad idea. Cerbral vampires have the exact same squeamish-horror theme. That, and they are already quite familiar with using vital fluids.

[Le Noir Faineant]

I recently dreamed of a strange pale ballerina... Do I have to worry?