Cable channel FX has decided to give professional life -- as shown on TV -- a makeover. Literally. FX wasn't about to trot out any of the old gray mares of workplace shows -- the comforting cops-n-lawyers format of Law & Order, the faux drama of ER's doctors, the ludicrous hysterics pumped into The Practice to make lawyering look sexy. Instead, the characters on FX's newest show are practitioners of that most au courant of professions: plastic surgery.

Nip/Tuck, which is a drama, comes on the heels of a slew of makeover-themed reality shows -- make over your face, body and house, thereby making over your whole life! -- that have only grown more garish with each new incarnation. The front-runner in this category is currently ABC's Extreme Makeover, which takes normal humans and turns them into anatomically enhanced mannequins or facsimiles of plastic talk-show hosts and toothpaste-commercial actors by dint of nose, boob, jaw and cheek jobs. Name a body part and there's a job to be done with it.

The makeover show takes that most American of pastimes -- personal transformation -- and turns it into family entertainment. Our nation's fondness for presto change no doubt has to do with our history as both a frontier country and a uniquely mobile society: In America, at least in theory, you can just discard your old identity and create yourself anew -- if you have the drive, the inclination and the ruthlessness. No collective community memory to thwart; no fuss, no muss.

As the hapless Dr. Sean McNamara (Dylan Walsh) of Nip/Tuck reminds us, external change is just one part of the process. "For 10 years I've been consumed with transforming other people,'' he rants. ''Starting today, I'm transforming myself!" It's all very Dr. Phil, and perhaps that's the point. In its nasty, messy drama of two plastic surgeons, Nip/Tuck wants to tell us just how sad our Oprah-ized culture is, just how self-absorbed we all are and just how brilliant the show is to choose the metaphor of plastic surgery to cut into the vacuous heart of upwardly mobile American malaise.

Nip/Tuck punctuates this social message with images of ass-implant surgery and liposuctions gone explosively awry, as if throwing gobs of fat at the audience will drive home just how ugly our self-improvement culture has become.

The show works best when it steps down from its gore-n-glam pulpit and lets its characters out of the tight confines of stereotype. Dr. Christian Troy (Julian McMahon) is the dashing, amoral rake who seduces beautiful young women, marks up all the flaws on their bodies and sends them screaming to the operating room. McNamara is his partner -- emotionally deadened, morally conflicted and about to lose his furious, desperate wife (Joely Richardson), who wants breast implants to put the spark back in their marriage. As the show's frustrated moral conscience, McNamara gets saddled with lines like, "We let people externalize the hatred they feel for themselves," while Troy runs around schmoozing, having loud sex and hitting on McNamara's wife.

Thankfully, when Nip/Tuck goes beneath the surface of its own plastic-surgery conceit -- when McNamara shows a cold-blooded competency in taking care of a nasty problem, when Troy reveals hidden darkness under his too-perfect smile -- the show finds some complexity. Richardson makes the show crackle with tension every time she's onscreen; with every glance she conveys her character's despair and the bitterness of dreams deferred.

The show shouldn't abandon its gimmick entirely, of course, but it should find something else to flay besides such straw-man statements as, "When you stop striving for perfection, you might as well be dead." Why not probe deeper into the truly complicated issues surrounding plastic surgery? How about dealing with the complex notion of people of color "deracinating" their appearance? Or the rhetoric of empowerment that increasingly surrounds women's decisions to operate? Or a male character who has insecurities about anything other than his penis? (Lots of penis anxiety here, even in just the first episode.)

As for our merry doctors, why do they want to perform plastic surgery anyway? Their midlife crises have them foundering, but one wonders what first drew them to the profession. During commercial breaks, I toggled over to Queer Eye for the Straight Guy and watched five gay men with impeccable taste mold helpless straight schlubs into handsome men. There was a clear sense of Pygmalion joy, a sort of creator chemistry that enlivened the show. Do the more extreme makeover artists of Nip/Tuck feel any such happiness? Or anything besides guilt and avarice?

FX has billed its series as a "disturbingly perfect new drama." Nip/Tuck is far from that. But if the show stops trying to disturb viewers with gory visions and quits struggling to perfect its relentless messages and pat characterizations, it could be better than perfect. It could be human -- warts and all.

Noy Thrupkaew is a Prospect contributing editor.

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