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Gruesome and Gripping

Plastic surgery becomes high drama in FX’s new summer hit.

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Ah, the promises of elective plastic surgery. The assurance of a new you. Who wouldn’t leap at the opportunity?

The answer to that question is, “Most of us wouldn’t.” Primarily because we can’t afford to pay for it out of our own pockets, and our medical plans won’t cover it unless the operation is a medical necessity. But, the insurance gatekeepers don’t agree that a nose like a movie star’s is important to our continued good health.

Nevertheless, we’re fascinated by the prospect of changing the way we look to the world. Who among us hasn’t looked sideways — and intently — at an acquaintance who’s just been away on vacation and returned looking better than what you’d expect from a mere month of relaxation. Didn’t he used to have bags under his eyes? Hasn’t she shifted up a notch or two in bra size?

With a multiplicity of TV channels fighting for our attention, how long did we think it would be before plastic surgery became the stuff of high drama on the tube? The only thing surprising is that it took so long.

Or is it?

In the FX network’s breakout summer drama “Nip/Tuck,” the focus of which is two plastic surgeons and their cases, what may be even more surprising is the moral dimensions of what follows from their opening question in each initial patient consultation: “Tell us what it is that you don’t like about yourself.”

As if plastic surgery could actually fix what really — deep down — bugs us about ourselves. Yeah, right.

Given all that, it’s no wonder that “Nip/Tuck” debuted with the highest ratings of any new show on cable this summer.

Granted, cosmetic surgeons Sean McNamara (Dylan Walsh) and Christian Troy (Julian McMahon), who practice in the South Beach area of Miami, take cases that involve medically necessary reconstructive surgery. But that’s so ... um ... “ER,” so last year. The cases that keep the show’s fans on the edge of their seats are the ones that focus on makeover surgery, the slicing and dicing that are more about self-gratification for the rich and foolish.

But good drama can’t survive purely on before-and-after images. There’s got to be a deeper meaning, otherwise all you’ve got is a fictionalized version of “Extreme Makeover.” So “Nip/Tuck” creator and producer Ryan Murphy, who also writes the scripts, gives us two surgeons who are polar opposites: one who’s in the game for the good he can do, and another who’s in it for the money he can make.

And because he knows you can’t break through the clutter without sex and violence nowadays, Murphy serves up heaping helpings of both. The sex is not all that shocking, but the violence is: The bloody bone-crushing and controlled brutality of cosmetic surgery is shown in graphic detail never seen before on TV. “Nip/Tuck” is not a show you’ll want to watch while munching on a pepperoni pizza.

Gruesome, yes. But gripping, too. “Nip/Tuck” doesn’t just push the envelope. It shreds it. S

“Nip/Tuck” airs Tuesdays from 10 p.m. to 11 p.m. on FX.

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