As a young girl, Tiffany was living at the Channard Institute where her mother was experimented on by Dr. Channard. She didn't talk much, the nurses called her Tiffany. It is unknown if that is her real name or that the nurses gave her that name. Dr. Channard was obsessed with Hell and gave Tiffany the Box, hoping she would solve its puzzle and open the gates to another world. She did and Pinhead and other Cenobites appeared. Tiffany was saved by Kirsty Cotton, who was at that time another patient of the Channard Institute.
Growing up, Tiffany dedicated her life to destroying the Hell's objects, like the Box. She even joined the Harrowers.
In a war against the forces of Abbadon, Harry D'Amour needed more Cenobites to fight against the invading forces. Tiffany volunteered to become one, ironically in the image of her mother.