Under the Knife

This is it! The first episode of the show that started it all... the mistruths about plastic surgery, that is. Honestly, I'm an optimist at heart, so I hate to nit/pick nip/tuck after only one episode, especially given that this is my first post, but you know what they say about first impressions and all.

So, what was my first impression of F/X's nip/tuck? Well, if I hadn't spent the last – and best – 20 years of my life working in the medical/aesthetics industry, I might have taken away the following from this pilot episode, which, by the way, I am going to call:

The Top 10 Things They Don't Teach You in Plastic Surgery School:

(Note: The following quotes – believable as they may seem – are actually taken directly from dialogue in the Pilot episode.)

• 1. Use, "I'm a plastic surgeon," as a pick-up line.
• 2. Remind people, "When you stop striving for perfection, you might as well be dead."
• 3. When injecting BOTOX® Cosmetic, comment to your patient that, "Tomorrow, you'll be one hot bitch."
• 4. Remember, you're in the "vanity business."
• 5. Remember, what you do is important because you, "let people externalize the hate they have for themselves."
• 6. Remember that as a plastic surgeon, you're in the, "placebo surgery market."
• 7. Always have a goal. For instance, Dr. Christian Troy wants a, "kick ass practice."
• 8. Be cool. Write doctor's excuses for kids so that they can skip school.
• 9. Drug money = new steam room.
• 10. When a patient tells you that they want to be "perfect," nod and inform the patient that with your help, they can, "absolutely be a '10.'"

Like most shows, this episode had multiple storylines: the first involved accepting a bribe from a mobster to perform plastic surgery that included over-the-top facial sculpting and out-of-control liposuction (both totally unrealistic); sleeping with a hot model and then selling her on everything from rhinoplasty and a tummy tuck to BOTOX® Cosmetic and breast enhancement (sure beats the Chamber of Commerce!); and, finally, dumping a dead patient's body in the everglades. Just another day at the office... the writers' office over at F/X!

Speaking of offices, in case you missed it, there was a quick shot of Dr. Troy's office door, which happened to display, "M.D. F.A.C.S." A little research will tell you that this indicates, "Medical Doctor, Fellow of the American College of Surgeons." A little more research will tell you that the ACS admits only those surgeons who, among other things, agree to practice ethical standards. Wait a minute, didn't the mafia boss – nicely portrayed by the always excellent Robert LaSardo – say that Dr. Troy was, "named by colleagues as someone lacking ethics?"

The fact is, plastic surgery has very little to do with "perfection," "vanity," or "hate." And, it's got absolutely nothing to do with bribes, sex, drugs and felonies. It's about your vision of you – no one else's. Don't believe me? Check out these cosmetic surgery videos and see for yourself

So, if you watched nip/tuck hoping to learn everything you've ever wanted to know about plastic surgery, unfortunately you really didn't learn anything in this first episode. Don't get me wrong, it was entertaining; it just wasn't informative. Oh, well, let's hope episode 2 better fulfills the promise of reality-based television.

Charlie Sheridan
Medical Editor and Consultant