The DSC Tabletop Gaming Club really enjoyed reading through Vicissitude Expanded. The introduced a new mechanic called Alterations, which are the various ways a Tzimisce can modify another being using flesh-crafting. There were quite a few to chose from. There is a very small section of the Path of Asakku and Transmutions, which could be expanded upon. The section on Ghouls which details the various monstrousities created by the Tzimisce is wonderfully laid out.
We kind of wish some mention of the souleaters from 2nd edition were mentioned.
Vicissitude Expanded is a welcome addition to any storyteller's library, especially those that have Tzimisce as the antagonists. Players in a Sabbat game might find the book of use. Players in a Camarilla based game would have no use for this book.