Nip/Tuck begins its fourth season exactly where this FX drama began, with gruesome surgery belied by jaunty pop music: in this case his-and-hers face lifts to the '70s disco tune Boogie Oogie Oogie.

Soap operas and Nip/Tuck are like Silly Putty, or, for that matter, the cosmetic filler Restylane. No matter how far and distortedly the characters are stretched, they always return to their original form. The two boyhood friends who share a plastic surgery practice in the South Beach have endured all kinds of baroque twists -- infidelity, abducted girlfriends, illegitimate children and a maniacal slasher -- but their personalities remain fixed, unmarked and buoyant.

So there is relief, delight and disappointment in seeing Sean McNamara (Dylan Walsh) and Christian Troy (Julian McMahon) once again at the bar of a swank Miami nightclub. Christian rises to greet two sexy, men-trawling women and beamingly announces, "We're doctors."

Most shows reach a point where they sag and suddenly strain in outrageous directions; it happened on Boston Legal, Desperate Housewives and many others. But Nip/Tuck started up where most other shows leave off: willfully absurd and over the top. The third season tried to outdo the first and second, and exhausted itself. The fourth season is trying to restore the show's balance of farce and melodrama.

The writers have recognized anew that the particular procedures clients seek are integral to the series: They chart the full range of human vanities and along that spectrum produce humor and pathos, and not merely a freak show.

Of course the love of the grotesque is hidden in plain sight in the casting. Nip/Tuck takes the current obsession with giving choice cameo parts to actors past their prime and runs wild with it: Larry Hagman, Brooke Shields and Kathleen Turner all have star turns in the debut episode, which encores at 11 tonight. Richard Chamberlain and Jacqueline Bisset are featured in the second. The future holds Rosie O'Donnell and Catherine Deneuve.

Hagman plays a billionaire with prostate cancer who wants testicle implants to reclaim his manhood and his young bride. Shields is Christian's therapist, a psychologist with issues of her own. And when the partners utter their ritual opening line to clients -- "Tell me what you don't like about yourself" -- Turner explains that she is a phone sex hostess who wants her larynx tightened so she will stop alienating clients with a voice that resembles a "geriatric bullfrog."

One would think any show that packs in everything from breast reduction to vocal cord lifts and testicle implants would find sufficient dramatic fodder under the knife to leave home life alone. And yet the new season is crammed with a whole new set of lurid plot lines, including lesbian blackmail, a sex-starved nanny and a genetically deformed baby.

The last line of the theme song fastens on the lyric "a perfect lie," and that is what Nip/Tuck is nominally about: the deceptions, physical, psychological and emotional, that fill out people's lives along with their wrinkles. But what on one hand sounds like an elegant metaphor also sounds very much like a description of any daytime soap opera. Nip/Tuck too often turns into General Hospital with liposuction instead of life support, and breast implants in lieu of amnesia and evil twins.

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