Overall I was pleasantly surprised with this novel. O'Keefe manages to grasp Shelley's tone well. She pulls off a sequel that could have been written by the original. I enjoyed watching all the humans turn to "monsters" as Victor himself became a man. The first two parts were simply to set the stage and remind us of the cycle of acceptance/rejection that Victor experiences through the original book; that is all of his relationships with humans start with acceptance and end in rejection. The repetition of the blind man (from the original French cottager) in the Italian beggar was unnecessary in my opinion (possibly used to set the tone, but really she could have cut at least 100 pages from the front end of the novel).
The meat of the novel comes when Victor goes to Tarkenville and meets Lily. Certainly this book could have started there. Overall I thought the fact that Lily was a product of incest was unnecessary (and obvious from Winterbourne's description of Margaret's obsession). It did feel at times that O'Keefe was reaching to subscribe to the Victorian prejudices and overly dramatic elements; but then again that is what made it such a well-done and seamless sequel.