Season two… finally! How long has it been? Too long! 245 days to be exact. I won’t be ignored, Ryan Murphy! A little Glenn Close for you. Okay, I’m rarin’ to go, so fasten your seatbelts boys and girls. I’m going to call this episode…

Daddy’s Little Helper

While I’m doing impersonations… in my best Marilyn Monroe, “Happy birthday to you, happy birthday to you, happy birthday, Dr. McNamara… happy birthday to you.” Sean’s turning the Big 4-0, and he’s having what’s known as a little mid-life crisis. Make that a big ole mid-life crisis. In fact, he can’t name anyone whose life improved after 40… well, a quick Internet search, and you know what I found? Nothing. Yeah… zip. I’m joking! In fact, here’s a comprehensive list of late-bloomers:

• Rodney Dangerfield
• Colonel Sanders
• Grandma Moses

Feel better? I don’t. I know, I’m not helping… and neither is Dr. Troy, who gives his best friend and business partner a syringe of BOTOX® Cosmetic as a gift; he’s even willing to inject it right there and then… done. Crisis averted… except that Dr. McNamara doesn’t believe he needs it (or at least, doesn’t want to believe it). Good, more for me!

According to the American Society of Plastic Surgeons®, BOTOX® Cosmetic was the number one cosmetic plastic surgery procedure in 2003 with 2,891,390 procedures performed – an increase of 157% over 2002’s numbers and up 267% from 2000. And, it’s not just women who are giving themselves the gift of smoother, more youthful looking skin, as men accounted for over 10% of all BOTOX® Cosmetic procedures in 2003… hey, better than buying a Corvette, if you ask me (and cheaper).

Sean’s problems run deeper, though, than a few wrinkles; he’s also hiding a mind/body condition he’s developed referred to as, “the yips.” Basically, it’s a nervous disorder brought on by anxiety in which the hand shakes uncontrollably at the most inopportune times, such as during plastic surgery… not good. Sean’s doctor had a brother-in-law (a golfer) who suffered from the yips. How did he treat it? “Quit the circuit… took the Jack Daniels route.” Sean takes a different road… Alprazolam, a prescription drug that not only treats anxiety disorders but also poses a real risk of dependency… not good.

The crazy thing is, what does Dr. McNamara really have to be stressed about? Dumping a dead patient’s body in the Everglades? Committing adultery with a patient who later died (and who he really loved)? Removing, at gunpoint, breast implants filled with liquid heroin from a drug lord’s “mules”? His sex-less, on-again/off-again marriage? Relax. Colonel Sanders didn’t throw in the towel! Take a chill pill… oh, yeah… he’s already doing that.

Sean of course has had incredible performance issues at home, so he certainly doesn’t need “the shakes” at work, especially given that he’s the talent. Hey, you know what would really help? If his mother-in-law (played by Julia’s real life mom, Vanessa Redgrave) would just come to stay for a while. Happy birthday! Oh, and she wants him to help her out with a little plastic surgery… a facelift (rhytidectomy) and a brow lift / forehead lift. He reluctantly agrees. Cue extended montage of plastic surgery videos, where Christian has to take over, because although his own 40th birthday is just two week’s after Sean’s, he’s dealing with middle age a little differently and consequently doesn’t have a problem “operating.”

“I plan on banging twice as many Mamazons this decade in far more depraved and debauched ways.” And Dr. Troy’s starting immediately… he hits up on a 25-year-old orthopedics resident at a club, but she recommends that he come back to the club on Thursdays for Oldies Night. She goes on to tell him, “Look, you’re cool, but I have a real daddy and I don’t need another one.” Christian doesn’t let it get to him… much… he simply does what any man in his position would… call her a, “bitter, lipstick lesbian,” and proceed to go home and screw the nanny. I can’t decide if this is better than buying a Corvette.

So, what else happened on this first episode of nip/tuck’s second season? A lot. Too much! Save something for episode 2. Well, we found out that Christian slept with Sean’s mother-in-law at Sean and Julia’s wedding. Oh, and he also slept with her when she came in for the consultation regarding her facelift. She later tells Julia, “I want to feel the way he made me feel for more than an hour.” An hour?!!! I want to feel the way Dr. Troy made her feel for, I don’t know, maybe more than two-minutes? Is that so much to ask?

See you next time.

Charlie Sheridan

Medical Editor and Consultant

So, here we are, 15 episodes in and the writers finally penned an episode about McNamara/Troy’s bad boy. This ought to be good. Hmmm, I think I’m going to call this episode…

Christian Troy

Boy, that was easy. If there’s one thing we’ve learned about Dr. Troy it’s that he’s a man who doesn’t mince words. And while this can be refreshing (sometimes) in real life and entertaining (sometimes) on reality based TV, his abusive words would NEVER be tolerated in the workplace, regardless of how good (looking) he is. In fact, if someone acted in real life the way Julian McMahon acts the part – especially the way he often talks to and treats his colleagues… well, let’s just say he or she would have a lawsuit on his or her hands in a Miami medical minute. With that said, thank goodness for Dr. Sean McNamara.

Sean’s soft-spoken, well-mannered, well meaning… definitely the better half of McNamara/Troy (probably, why he hasn’t had an episode named after him yet)… can you say, BORING? Sean’s wife can. Anyway, he’s a real professional… except when he refuses to admit that he still suffers with the yips (shakes), almost killing a patient during surgery to remove a “hematoma from hell” from the man’s neck. Hey, how could he know something might go wrong? I mean, a scalpel, a golf-ball sized collection of clotted blood, veins, arteries and the shakes… what’s the problem? No problem. If something happens – and of course it does, because it’s TV – just blame the patient’s brush with the big sleep and a prolonged recovery on the anesthesiologist. I mean, that’s what they’re for, right? No biggie. But, enough about Dr. McNamara; this is Dr. Troy’s time to shine… besides, it’s not like Sean is his only partner.

Dr. Troy’s had lots of partners… and just because they’re not in business with him doesn’t mean they’re not professionals. Although on this particular evening, he obviously got down to business with an amateur, seeing as he had to coach her through performing oral sex. Anyway, before he even had time to officially score her “bedroom acrobatics,” she accidentally broke his “perfect” nose. Again, no problem, his business partner and best friend is a plastic surgeon. Of course, would you trust someone with the shakes to perform your rhinoplasty? Dr. Troy doesn’t… so, it’s off to see Dr. Monica Jordan.

Things are going great at Dr. Jordan’s: Christian steals one of her patients, a man with a supernumerary nipple… or “nubbin” for you fans of “Friends’,” Chandler Bing. Things are going so well, in fact, that Christian decides they should have sex… with Dr. Jordan, not the dude with the third nipple. So, he gets naked. Then, Dr. Jordan gives him a taste of his own medicine, telling him that he would really benefit from liposuction to remove those “love handles” and Restylane® to “soften the puppet lines around your mouth.” Screwed again… just not in the good way. Well, there’s only one thing left to do… perform the rhinoplasty himself. You ever try to cut your own hair? Yeah…

By the way, 14 blogs behind me, and I can’t remember if I ever confirmed that, yes, most plastic surgeons do fire up the stereo during a procedure; the ritual actually helps the doctor to relax and focus on his work, all while tapping into his artistic abilities. Plastic surgery is, after all, an art form. So, the next time nip/tuck shows a CD being put in before videos of rhinoplasty or liposuction videos, there’s some truth there. Here? Well, it’s just Dr. Troy in his Gucci briefs standing in front of a mirror to perform nose surgery on himself. Needless to say, his DIY rhinoplasty didn’t quite go as he had hoped. In fact, rather than the “perfect nose,” he gave himself a really, really bloody one.

In the end, Christian asks his friend and fellow plastic surgeon, Dr. McNamara, to perform his revision rhinoplasty (nose surgery to correct a botched nose job). And, in the hopes of helping his friend regain his confidence, Christian opts for no anesthesia… I’m sure the co-workers he’s demeaned on a daily basis didn’t have a problem with his request.

Oh well, not exactly the episode I looked forward to with such great anticipation, but not bad… just inaccurate. That’s Hollywood, and that’s all folks!

See you next time.

Charlie Sheridan

Medical Editor and Consultant

We all want a hot and steamy sex life… and by “we” I mean “I”… but really folks, it ain’t gonna happen at your plastic surgeon’s office. Believe me, I work (live) at one. So, unless you happen to be the patient of the egotistical and uber-sexual Dr. Christian Troy, again… not gonna happen. Oh, and since he isn’t real, if you think it might happen, you need to either cut back on the meds… or increase them. But, hey, I’m not a psychiatrist.

Something else that isn’t real? Surprise! That’s right, most of what happened on this week’s nip/tuck. It’s unfortunate. It’s also unfortunate… actually, that’s way too soft of a word… it’s also incredibly cruel… barbaric… that in some countries, men AND women still engage in a sadistic ritual of genital mutilation on young girls. It’s sick. And, it’s the focus of this episode, one I’m going to call…

If We Could, We Would

There’s a lot of truly amazing… not strong enough a word… miraculous things that plastic surgeons do everyday with elective surgery in this country to improve not only someone’s look but their outlook as well. There are also many ways that surgeons reach out to needy men, women and children around the world. So, you can only imagine when one has a consultation with a patient they can’t help. It’s a horrible feeling. In this episode, Manya Mabika is just such a patient (except that you wouldn’t know it… stick with).

Ms. Mabika is a top model, and a Somali woman, who like real-life model, Waris Dirie, was a victim of genital mutilation. She not only has to live with the daily reminder of her torture, but is unable to experience any pleasurable sensation related to sex. Probably, not what Dr. McNamara and Dr. Troy were expecting when they asked their usual, “So, tell me what you don’t like about yourself.”

Fortunately for her – and unfortunately for viewers looking for the facts – they inform her that there’s a procedure where they can perform a free flap transfer (the transfer of tissue from one body part to another), rebuilding her clitoris with tissue removed from one of her toes. They refer to this micro-surgical free tissue replantation as an “experimental” procedure. Damn straight. In fact, when it comes to reconstructing the clitoris, it’s actually called science fiction.

While procedures such as labiaplasty are becoming increasingly popular, regrettably, I can assure you that no toe will ever completely repair the damage done. While surgeons periodically meet with patients living with the devastating condition of clitoral mutilation, the fact is, there’s little hope for 100% repair. Moreover, any nifty idea that a plastic surgeon may have in his little doctor’s bag of tricks to reconstruct the clitoris would absolutely, positively need to be medically tried and tested before being performed on a walk-in.

Of course, this sort of dramatic story telling not only leads to the inevitable Emmy nomination, but also to dialogue that’s an absolute joke. Here, Dr. Troy argues about why he is most suited to perform the surgery:

• Dr. Troy: “You might be more adept at nerve reattachment, Sean, but I am a GD genius when it comes to pussy. If I build it she will come.”

Guy talk, I guess, except that they’re talking about a woman that was tortured. Ultimately, they flip a coin… OMG! Anyway, lo and behold, there’s a happy ending… well, not for Dr. Troy who graciously decides to volunteer his services to test out his masterpiece. Unfortunately, poor Christian fails to give his patient “the big O,” although, Liz – the practice’s lovely anesthesiologist (and practicing lesbian… and conscious of McNamara/Troy) – doesn’t have the same problem. Don’t feel bad, Dr. Troy, it happens. Anyway, Liz just tells the woman that she’s got to learn how to “love herself” before she can experience satisfaction from someone else loving her. Now they tell me!

Unrealistic expectations and unethical behavior… exactly what we’ve come to expect with nip/tuck.

See you next time.

Charlie Sheridan

Medical Editor and Consultant

You remember Mrs. Grubman? Sean and Christian haven’t forgotten her; they can’t. Just in case you have, she’s McNamara/Troy’s number one patient. I know what you’re thinking: “Hey, Charlie, how can I become a plastic surgery practice’s number one patient? Sounds fun!” Well, on TV, it’s as easy as… one, be insanely rich; two, don’t be above blackmailing your surgeons after they fail to remove a cautery tip before sewing you up (oops!); and, three… be addicted to plastic surgery! It’s just that easy. Of course, in real life, it’s even easier, because for real plastic surgeons, every patient is his or her number one patient. Corny, maybe, but true. Anyway, I’m going to call this episode…

The Queen B’s Knees

The show opened with “lunchtime liposuction” being performed on a high school cheerleader. C’mon! Totally unrealistic! They don’t have pockets of problem fat! And even if they did (they don’t), they wouldn’t have it removed over lunch (they would just break-up with him). Look, although lipo is a simple, routine procedure that over 320,000 men and women had done in 2003, it’s still a surgical procedure and is not to be taken lightly; it’s not like getting your nails done. Seriously. We’re talking about anesthesia, and at least a couple of hours of recovery. At least, that’s what I’m talking about. You know you can email me, right? Anyway, the amount of fat Nurse Liz disposed of? Yeah, that’s not being removed over lunch… although I’m sure some viewers had their dinner involuntarily removed during the liposuction videos.

Speaking of knees… they’re not like the hands or the face. Sure, they show the signs of aging, but you can easily cover them. The knees… c’mon, who thinks about them? Mrs. Grubman, that’s who. Hey, after something like ten or eleven surgeries in a six-month time span (unrealistic), she’s gotta be thinking all the time, because she’s running out of things to fix.

Unfortunately, there are things that even a plastic surgeon can’t fix. Such as? Such as deep-rooted emotional problems that cause you to feel like you’ve, “lost the race against time,” as Mrs. Grubman said. Unfortunately for her, a plastic surgeon can’t do his or her job – in this case the rarely performed knee lift – when a patient isn’t completely honest (or, when a doctor isn’t honest with his or herself). Mrs. Grubman hid the fact that she was taking anti-depressants. McNamara and Troy hid from themselves the fact that she probably suffered from Body Dysmorphic Disorder (BDD), a condition in which the person is obsessed with an imagined physical defect. This culture of lies led to Mrs. Grubman arresting shortly after receiving anesthesia, ultimately suffering a debilitating intracerebral hemorrhage. She wanted something to work on and she got it – learning to walk and talk again. Moral of the story: don’t lie… to yourself or to your plastic surgeon.

So, what else happened in this episode? Well, we found out that Kimber’s cocaine career will have to be cut short because it’s caused a hole in the septum in her nose; we then watched some heartfelt videos of rhinoplasty as Dr. Troy fixed her nose. Oh, and it was revealed that Christian was raised Catholic… well, that explains a lot. What wasn’t explained was how he didn’t immediately burst into flames when he entered the church to witness his baby boy, Wilbur’s, baptism. Unfortunately, the boy’s biological father decided he wants custody of Wilbur – effective immediately – leaving Christian alone at the altar. Always a godfather, never a father.

See you next time.

Charlie Sheridan

Medical Editor and Consultant

I like to think that I’m here to help point out the differences between the ridiculous things that happen every week on nip/tuck and the positive, life-enhancing sort of things that happen everyday at a real plastic surgery practice. I know, the job’s pretty easy. For instance, this week, Dr. Troy said, “I slide on a johnny hat every time I perform a slipindicktomy on a woman of questionable standards.” Well, I’m here to tell you that there’s NO SUCH THING as a slipindicktomy… I’ve never seen it… never heard of it… it’s made up. Oh, and Dr. Troy… I’m pretty sure it’s called a “jimmy hat.” Anyway… I’m going to call this episode…

NUMB NOSE, NUMB SOUL… NUMBSKULLS

We know Sean has a wife and kids and that he works over 70 hours a week. So, he must really take advantage of what little free time happens to come his way… you know, live a little. Yeah, he likes to read Consumer Reports. “I’m very bold,” he says. Dr. Troy… your rebuttal? You have five seconds. “Want to be bold, Sean? Start slow. Wear some flat front pants.” Hey, good advice for anyone. Anyway, this week, the two best friends and business partners consult with patient, Joel Gideon.

Joel’s suffering from the effects of severe frostbite across his cheeks resulting from a fall during his climb of Chomolungma… also known as Mount Everest. Sean would never attempt such a foolish act; he’s got kids! Christian wouldn’t either; there’s nothing up there to have sex with. Besides, he loves his physical self way too much to jeopardize it for something as fleeting as spiritual gain. Oh, well.

Oh! Joel’s got a wife and kids as well. Hmmm… then why’s the damn fool climbing mountains? Is he nuts? Because he’d “rather have a numb nose than a numb soul.” You see, he doesn’t want his kids growing up fearful of life, forever hiding in their houses behind the “steely integrity” of America’s most trusted product review periodical. Really? That’s nice. Good luck. Well, McNamara/Troy can’t help you if you’re going to make them feel bad. Come on now… of course they help him with a nose job, using skin grafts harvested from other sites on his body to reconstruct his face. And, exactly how does Joel repay them? Besides his sincere thanks, you mean? Well, he inspires them to take chances… yeah, he’s obviously still gotta pay the bill, though. I mean, thanks and inspiration are great, but they don’t feed the bulldog.

And so Dr. Troy embarked on a custody battle for Wilbur, a boy given the incredible gift of life by Troy’s sexaholic, off-again/let’s-get-it-on-again girlfriend and a sixty-something year old man she slept with at the Airport Ramada. Don’t act like you haven’t done it! Anyway, of course, Dr. Troy lost (everybody sort of lost in this storyline), but at least he tried. Dr. McNamara? Well, he ate some fugu (poisonous Japanese blowfish) and almost went swimming with some sharks. Again, at least he tried… almost.

And, the writers at F/X will undoubtedly give it another try!

See you next time.

Charlie Sheridan

Medical Editor and Consultant