A mixed-method, qualitative dominant design was implemented to understand how visible changes in appearance, and function, govern childhood burn survivors' and their siblings' perceptions of their body image (BI). Thirteen cases (n = 21 participants) contributed to this analysis. Each “case” represented a family unit. Findings were internal to the person (grouped as self-esteem, and personality type). Other findings were external to the person (grouped as the social environment and interpersonal experiences of the siblings). Findings suggest that the children focused on developing a positive BI satisfaction. Research is needed to better understand how this occurs despite visible appearance changes.