Drama of skin deep beauty

Nip/Tuck has been widely billed as The Sopranos meets Six Feet Under, which I guess is because it has got a hell of a lot of blood in it, and also some death. That said, it might be about plastic surgeons, but this is essentially still a hospital drama so the ratio of actual expiry to bloodshed is pretty low.

When someone makes an incision in The Sopranos you know things aren't going to go well; here, it could be nothing more sinister than a woman of a certain age seeking more tautness around her eyes.

Julian MacMahon is the naughty doctor, single, philandering, botox-crazy (he takes syringes of the loveable virus to parties, to ingratiate himself with pretty cokeheads) and treading a thin line between likeable rogue and son of Satan. Dylan Walsh is the married doctor with kids and a conscience, treading a thinner line between righteous man and hypocritical prig. Joely Richardson is very plausible and improbably cool as his wife.

Incidentally, this is another thing the show has in common with Six Feet Under - the discovery of phenomenally good-looking middle youth men who can act, but have never been in anything you could remember in the past 20 years. Do they grow these guys underground?

Anyhow, the pair are basically water-bombed with every conceivable ethical issue that could ever attach to plastic surgery. They cannot get to the end of a corridor without hitting a doctor's dilemma, often of a properly unusual nature.

Do you operate on a man who needs to change his face because he's molested his mobster boss's six-year-old? (Answer: nope, not if you know what's good for you).

Do you do liposuction on neurotics because it's more lucrative than operating on burns victims? (Answer: well, not ideally). Do you take home a model from a bar, tell her she's lying about her age, point out her imperfections, draw all over her with lipstick to indicate where you'd nip and where you'd tuck, then never return her calls? (Answer: not unless you want to hear the plaintive, all-American whimper, "Am I that ugly? I was Homecoming Queen!"). What do you say when your wife wants a boob job? (Answer: no, emphatically not, "isn't it a bit late for all that now?").

The script makes a decent fist of examining the culture of plastic surgery, with cod-psychological musings along the lines of "All we're doing is externalising the things people hate about themselves".

But throughout, you are left with the uncomfortable feeling it's all a bit silly, this business. It's hard to take people seriously as victims when the only thing that brought them into contact with this nefarious world was vanity. Sure, vanity isn't the end of the world; and nobody needs the goodies to be purely and eternally good, like in Dickens. But you need them to have a sense of their own shortcomings that relates to something beyond the sagginess of their bristols.

It's like watching a drama about middle-aged men who think they can still retrain as professional footballers, and the women who exploit their delusions by, er, giving them pricey sports massages. Part of you admires the nuance, the blurring of your sympathies - and part of you thinks, you are all just daft. No amount of gangster paedophiles is going to mask the daftness. When's the next season of West Wing?