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I saw a show in about 1974 that I thought it was on Twilight Zone or Night Gallery. It has a kid or teen was so hideously ugly he was kept hidden by his parents. I believe in a brief glimpse he is seen as having a funnel-shaped head and parents are ashamed but love him.

Then alien life is made contact with, but not seen. They agree to exchange one of theirs for one of ours. At the end even with the heartbreak of losing their son, the parents agree. Lo and behold, the alien is a (to us) beautiful young boy, and the boy from Earth goes to a world where they all have that inverted funnel-shaped head, and everybody is happy. It is an old story but I'm sure I saw it. Has anyone else?

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The date and description don't match exactly, but the story sounds like my answer to this question on Movies & TV. The plot is similar to Henry Slesar's Job Offer.

Possibly an epsiode of Night Gallery, The Different Ones.

Based on The Eye of the Beholder from The Twilight Zone.

From Wikipedia's description of The Eye of the Beholder:

The episode was written by Rod Serling, who recycled the theme for a later teleplay "The Different Ones" for his later series Night Gallery. This one takes place in a futuristic world where a disfigured hermit teenage boy is sent on a NASA rocket to a planet where the inhabitants are revealed to look like him. During the transfer he meets a handsome (by human standards) alien youth, who is going to Earth due to his own disfigurement.

I can't find a video clip, but here's an image:

The Different Ones

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While this is not likely the show you describe, I thought I'd mention it anyway since it may be based on your show, or it may spark someone else's recollection, or something helpful. This is a short story called "Clothes Make the Man" by Neal Shusterman, I found it in Mindstorms: Stories to Blow Your Mind.

In the short story, there is a mixup between two kid's luggage while traveling - each picked up the wrong suitcase. As the protagonist kid ended up using the contents of the luggage (having nothing else, mostly), he found himself adapting to it

he fits the clothing - including growing a third arm, he develops an appetite for the alien food (a can of worms) while loosing interest in regular food, and I think picking up alien language.

The story indeed ends with the other kid's family showing up to swap the kids so both could be accepted (since the other kid had likewise adapted to this kid's items). The story ends with everyone pretty happy, and the kid's new parents teaching him to read their language.

The matching elements are the kids being swapped, looking like each other's people, and a happy-ish ending. The backstory (why they look different) doesn't seem quite the same, and the specific differences between the people's appearances is also different. Also, obviously, the difference between a show and a short story is also relevant, and the timeline is off (1996).

But while it may not be what you're looking for, I thought it might be related, it may spark someone else's memory, it may be someone saw your title but was looking for this work, so I thought I'd offer.

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