The new boss is insulting my appearance

The first and most preferable option is to discuss this with her directly and honestly. Use the SBI (Situation/Behavior/Impact) framework. Describe the situation. Describe her behavior. Enumerate how it impacted you. Don't just complain. Empathize that you understand it makes her uncomfortable, and that her commentary is creating an unfriendly and stressful work environment. It will be an uncomfortable conversation, so it's important to remain calm and purposeful. Don't trauma dump. Be specific and deliberate.

If you don't feel comfortable with this person specifically, your next option is their manager/supervisor. Set up a meeting with this person. Do all of the things above exactly the same way. The only difference is that you have to add on the extra notion that you didn't feel comfortable or safe addressing her directly. You have to be prepared to share why. It's clear she was already offensive, so it is not a stretch to explain this as a primary reason for a lack of psychological safety.

If you don't feel comfortable with that, you will need to go to HR. In this case, HR actually is a bit of your friend (ironically). This person's behavior is creating a toxic condition in the workplace for which they may ultimately be legally liable for a harassment situation. They may be legally liable in THIS situation depending on locale. I would recommend using HR as a last resort as it will create a LOT of documentation and invasive investigation discussions. Let that not be a discouragement for you in that endeavor as much as a caution that it should be a deliberate choice.

Finally, if your company has a hotline for reporting, you can report the incident anonymously. Most people would recommend this as a first response. I recommend it last because this vector creates a magical target on you. These reports tend to surface all the way up to the board members. While they're "anonymous", the report would need to be sufficiently specific in a way that would identify you anyway regardless of who reports it.

My recommendation is the first option. Give this person an opportunity to make it right. They may not deserve it. They may be a complete jerk. Not giving them an opportunity to make it right reduces you to that level in a very "eye for an eye" way. The other options are always still there if they don't make it right. If they do make it right, you gain an ally and a better workplace.

Edit note: This post is written with the premise "Never attribute to malice what is more easily explained by ignorance or incompetence" (Hanlon's razor). If the malice is the genuine answer, HR is where this will end up.

Additional Edit: The SBI framework for situation/behavior/impact decisions can be learned about on this site and others similar to it. https://www.ccl.org/articles/leading-effectively-articles/closing-the-gap-between-intent-vs-impact-sbii/

Don't Go to HR, and consider carefully whether you should talk this out

Sure, when everybody is an adult, talking it out is great. But if your new boss is a jerk (you know the term I mean), a narcissist, or even a sociopath, this will crater your job on their terms and timing. I want you to remember this: All it takes is one bad boss to end your job. It is fairly clear that you don't have an existing good relaionship with this boss. Consider carefully how to approach this.

If you really need this job, you just take it. If you have other options, you make sure those options still exist before taking it up with the boss. Only you know what value you have in the organization and what your support will be up the chain.

If you talk to HR, the first person they will call is the boss. It is possible you can win against a boss, but losing against a boss means finding a new job. HR works for management, not for you.

I’m really sorry you’re dealing with this. Having a manager make comments about your appearance isn’t just uncomfortable, it undermines your sense of safety at work. You deserve respect, and this kind of behavior is not part of a healthy professional environment.

The first step is to protect yourself. Document what was said, when it happened, and how it made you feel. Keeping a simple record helps you spot patterns and gives you clarity if you need to escalate. If you feel safe enough, you might have a calm one-on-one conversation with your boss to say, “I want to keep our interactions focused on work. Comments about my appearance make me uncomfortable.” Sometimes people don’t realize how their words land until it’s spelled out for them.

If the behavior continues or you don’t feel comfortable addressing it directly, reach out to HR or another trusted manager. Framing it in terms of wanting a professional environment for everyone often makes it easier to raise. If your company doesn’t have HR or the culture feels unsafe, it’s valid to start thinking about other opportunities where you’ll be valued for your skills, not your looks.

None of this is your fault. You’re right to take it seriously. Whether you address it directly, escalate it, or eventually choose to move on, the important thing is to put your well-being first. You have every right to work in a place where you’re respected.

There were witnesses, so there is no denying the incident took place. At least one or two of those present would have been sympathetic enough to await your taking action so they will back you if you take it further. If you decide to stomach it, the incident could repeat itself, but worse still, others both junior or senior could feel you don't mind and turn it into a regular banter.

Having said that, here are some uncomfortable things to consider:

1. Competence 1.1. Does your previous boss feel you were not demanding enough of your departmental staff, and alluded to it during his regular or annual appraisal meetings - which could be seen as incompetent or ineffective leadership? 1.2. Does this new boss feel you are not demanding enough of your departmental staff - your quote: "I noticed she demand my other staff in subtle ways ..." which could be seen as undermining your leadership?

2. You say you are a boss yourself - you might personnaly consider yourself as a fair (or kind) boss, but 2.1. do your subordinates think of you as being a fair (or nice, kind, toughtful) boss? 2.2. do your subordinates think they could do a better job than you (make staff more productive, happy, etc.)

3. Appearance 3.2. Before your operation, did members of the workforce feel comfortable looking at you? 3.3. After your operation, did members of the workforce feel less uncomfortable looking at you, tolerate your appearance, or would they rather want to run a mile from you?

   Who did your job during your leave of absence? Did that person feel getting rid of you is worth it? In cases 2 and 3, your present boss might have been empowered by negative comments while you were on leave of absence. Worse still, if a particular member of the senior management didn't feel comfortable because of your mannerisms or appearance, could they have hoped the appointment or promotion of the consultant (who probably made her feelings known about non-handsome people) as your new boss will eventually drive you away without too much cost to the company - constructive dismissal?

If you feel another job will be really difficult to get and enjoy, then you might feel powerless and do nothing. But if your present predicament is intolerable, HR is your last recourse - you either win or not. However, if you loose, it will be at some cost to the company. Make an immediate appointment with HR. As the meeting was attended by XX number of people there will be no shortage of witnesses. Also emphasise that it was terribly upsetting and could set a precedent and the risk of legitimising such behaviour by any other member of staff. Few people get to the top without a modicum of decency, so be assured that someone in top management would be appalled by her behaviour and endeavour to look after your interests.

As alluded to by the reply by @Hilmar, a country tag would have been helpful. Some countries require disabilities to be registered before being offered an interview and employment. If a disability developed after employment has commenced, the regulation could allow the company to let the employee go, particularly if there is no alternative position for that employee as could be the case in a very small organisation. Conversely, a new candidate (junior or senior) could decide not to work in that company because they are intolerant (of working with a type of disability or wrong gender, race, religion). But if they do decide to work there, it is safe to assume the new employee understands the etiquette (and tolerance) required in dealing with existing employees. This appears to be your strongest point with HR - at least HR should have acquainted the new boss with the disability condition and the behaviour of the new boss is clearly unacceptable. At the very least, a written warning will be in the company's interest, or if it falls under the company's gross misconduct codes, an outright dismissal of the boss.