On TV: Botox. Face-lifts. Reconstructive surgery.

I know we’re all supposed to be watching this season of “Dancing With the Stars” to see whether professional athletics or Broadway provides a better foundation for dance. But I’m pretty sure most of us are far too preoccupied with figuring out whether Priscilla Presley has had the first successful head transplant and why there wasn’t a “Frontline” or at least an E! special about it.

According to People magazine, she was treated by an unlicensed surgeon and is planning to undergo more surgery to correct it, which I cannot imagine is going to help.

Meanwhile, whenever the woman is on screen it is virtually impossible to look anywhere else -- at once puffy and yanked, her face, and its odd relationship to her neck, often takes on the dimensions of a Picasso painting. A finer mind would seize the opportunity and contemplate the larger issues of humanity -- the nature of identity, our denial of mortality, the tyranny of beauty. Me, I just sit there, open-mouthed, the same questions turning like a hamster wheel in my brain: What on earth did she do to herself? And why?

It is a question that arises with alarming frequency while watching television these days. Cosmetic surgery among performers is certainly not new; face-lifts, and the accompanying jokes, seemed the birthright of many of TV’s pioneers. Joan Rivers has talked about her surgery so many times over the years that it’s part of her IMDB listing, which probably explains why she has of late taken to the stage -- the light is so much more forgiving. Indeed plastic surgery is so ubiquitous, so acceptable, it has, ahem, carved out its own genre -- from reality makeover shows to FX’s “Nip/Tuck,” lipo, lifts, Botox and implants are as much a part of the cultural conversation as braces and contact lenses.

Except braces are temporary, contact lenses invisible and cosmetic surgery, well, it seems to have gotten out of hand. For a critic, this poses a dilemma -- while it is appropriate, indeed, necessary to point out technical things like disruptive camera work or shoddy set design, what exactly are you supposed to say about an older actor’s strange shininess, newly bee-stung lips or eyes that seem to have changed shape and placement? Especially since no one in Hollywood but Joan, Dolly Parton, and Kathy Griffin owns up to having work done.

Google the name of almost any female actor older than 20 and the term “cosmetic surgery,” and you will be deluged with blogs and websites devoted to deconstructing famous faces and figures, often in the most clinical terms -- several of the sites are run, apparently, by actual surgeons who offer their expert analysis. But among those who are being analyzed, plastic surgery has become like gambling in Las Vegas -- a billion-dollar industry that no one admits to paying for.

So to avoid those angry denials through publicists, and to appear above the prole- tariat fixation with appearance, mostly we in the mainstream press say nothing. Or rather we say nothing in print and then run into our editor’s office to say what everyone else across the country is saying: “Oh, my Lord, did you see what she did to her face?”

Me, I think it’s time to come clean. If cosmetic surgery and other age-battling or appearance-altering procedures are part of the zeitgeist, then we need to figure out a way to discuss it critically without seeming like we are engaging in some form of gotcha.

Watching 78-year-old Barbara Walters, for example, her face painfully taut and shiny as she trailed through research facilities devoted to slowing down the aging process on “Live to 150? Can You Do It?” was an almost surreal experience, but what to say? Though Vanessa Williams recently gushed over the wonders of Botox on a Walters special, the famous interviewer has never made a similar admission.

When Carrie Fisher began popping up again last year -- as a divorce lawyer in “Weeds,” as a crazy former TV writer on “30 Rock” -- we were all so glad to see her working again, no one quite had the heart to mention that her face was so changed you had to hit the rewind button a few times to make sure it was her. And, mercifully, the short-lived “Viva Laughlin” was so all-around bad that no one felt obligated to dwell on, or even mention, the much-speculated-upon changes to Melanie Griffith’s visage.

It’s impossible to know what exactly has happened in each case -- age, genetics, hard living, bad lighting, good lighting, Botox or plastic surgery. Whatever, it’s the new -- and wrinkle-free! -- elephant in the living room. Despite a tacit understanding that actors nowadays start lifting and injecting on their 21st birthday, mentioning an inexplicable altered appearance remains strangely taboo.

It’s a tough town

BEFORE I go any further, let me be clear: I begrudge no woman, or man, any surgical or chemical enhancements. At this point, I’ve just about given up on even trying to keep track of psycho weight loss or breast implants among actors -- remember watching various women of “Friends” and “Ally McBeal” shrink to identical size zeros right before our very eyes? Whatever. That’s Hollywood. If you want to publicly starve to death or, in the case of the cast of “The Sopranos,” risk collective congestive heart failure, that’s your business.

People should be free to look as they choose, and this town is tough on women -- don’t talk to me about Judi Dench and Helen Mirren, they’re British. Would an American woman ever get away with anything approaching Nicolas Cage’s hair or James Spader’s increasing portliness? Of course not.

But television is a visual art, and if people are going to significantly alter the way they look in ways not directly connected with the roles they are playing, it can affect not only their performance but the whole tone of the show.

So you tell me, what is a critic supposed to say when part of the problem with a show is that the leading lady’s face seems incapable of movement or her eyes appear to be moving toward the sides of her head or her lips just look weird?

Reviewing many of the new shows for the past fall season and midseason replacements, I noticed at least three fairly famous faces that looked decidedly, and distractingly, different, frozen or tugged into almost immobility that made certain emotional scenes almost laughable.

Did I mention this in my reviews? No, I did not, even though I felt whatever procedure had been done clearly presented dramatic problems. I didn’t because none of these women has publicly acknowledged anything more drastic than facials, and I thought that to suggest that these women looked shiny, injected or just “off” would be mean and possibly sexist.

If women look old, we criticize, and if they try to fix it, we criticize more snidely. Frankly, I don’t care if an actor wants to yank the whole epidermis up with Scotch tape and baling wire as long as he or she looks human and is still able to act. Unfortunately, unless you are Catherine Deneuve, you can’t act if your face is petrified. Which is why I won’t even watch “Desperate Housewives” anymore -- I live in fear of the day Felicity Huffman succumbs to whatever package paralysis deal they’ve got going on over there.

What normal looks like

ACTUALLY, the Wisteria Lane ladies may be a fine example of art imitating life. Nicollette Sheridan has repeatedly denied facial surgery, Teri Hatcher has both admitted and denied Botox, and Marcia Cross remains silent. But even if they had a plastic surgeon on set, it would work for the hyper-reality of the characters -- neurotic women in a constant state of sexual upset are not expected to age gracefully.

What, however, are we to make of all the young women and their already-mutating dimensions? Lara Flynn Boyle was virtually unrecognizable on a recent “Law & Order” -- though it is to be hoped that the rounder face is because of weight gain (no one puts on pounds in their lips) and she’s too young to be worrying about wrinkles.

Which isn’t to say there isn’t public outcry. For years, we’ve all rooted for Jennifer Aniston even as she gradually whittled down her nose along with the rest of her body. But poor old Ashley Tisdale got whaled on in the press for a similar “deviated septum repair.” Maybe because she’s a Disney girl, and people fear she’s too young to have heard of Jennifer Grey, whose nose job so famously derailed her career that she parodied herself in the 1999 show “It’s Like, You Know.”

If TV critics are mostly mute on the subject, the blogosphere is not. Outing cosmetic sur- gery seems to be one of the reasons the Internet was invented, but in a way, it’s a zero-sum game. For one thing, you have to figure that surgically enhanced stars are like adulterous politicians -- for every one who gets outed, there are three more quietly passing. And what does it matter, except when it affects the person’s performance?

But when we see bad things happen to good faces, when cosmetic decisions interfere with performances, I think we need to speak out. Otherwise the younger generation will think that a fish-mouth smile and those shiny cheeks are normal and that the Posh Beckham look is something to aspire to.

For me, I wish everyone would stop not only because the sight of some ill-advised surgery or injection can wreck a perfectly OK television show, but also because I am afraid we will forget what normal looks like. Whenever I see women like Angela Lansbury or the late Geraldine Page or Marion Ross, I am filled with gratitude. Not just for the nature of their talent but because their faces always remained precisely and gloriously their faces.

Now, of course, someone will e-mail me with details of all their cosmetic surgeries and I’ll have to shoot myself in the head . . . but I’ll do it with Botox, because these smile lines are really becoming pronounced and someone might ask me to go on television.

mary.mcnamara @latimes.com