The Miami macabre of ‘Nip/Tuck’

Until “Nip/Tuck” kicked off its second season last week, it was still possible to enjoy the show as the flamboyantly vulgar, darkly satirical soap that it is while completely failing to appreciate the gothic horror story quivering exquisitely underneath it, like Percy Bysshe Shelley after one of Mary’s stories.

An original FX drama about a pair of Miami plastic surgeons, the dementedly emotional and extraordinarily grotesque “Nip/Tuck” owes more than just visible sutures to “Frankenstein.” Last week, Drs. Sean McNamara (Dylan Walsh) and Christian Troy (Julian McMahon) met Libby Zucker (Romy Rosemont), a patient requiring major reconstructive surgery on a macabre facial gunshot wound -- bestowed by her best friend in a botched birthday present-suicide pact combo.

“Tell me what you didn’t like about yourself,” hazards Christian, trying a slight variation on their trademark consultation icebreaker. What Libby didn’t like about herself, we learn, was not having “made it” by 34; not having made it by 34 -- or, hey, even turning 34 at all -- being the modern psychological equivalent of being surrounded by villagers brandishing pitchforks. Combine Libby’s abandonment issues and baleful personality with a face like a patchwork quilt pieced together from bits of leg, and it’s immediately clear that, like many of Sean and Christian’s patients, she is a doomed Frankengirl whom no amount of surgery can make human again.

“Nip/Tuck” elicits a distinctly late 20th, early 21st century kind of horror. And a gothic dualism slashes through the show like that ubiquitous virgule. The show’s outwardly cool, collected main characters spend much of their time beating down their bubbling ids and fighting back powerful surges of guilt. But these things have a way of overtaking people. The medical practice McNamara/Troy is a single -- albeit two-sided -- entity. The conscientious and anxious Sean and the promiscuous and rakish Christian are not so much an angel and a devil sharing a pair of shoulders as they are Jekyll & Hyde.

Christian, Sean and Sean’s disappointed, mildly depressed wife, Julia (Joely Richardson), are addled by superstitious fears: that life peaks at 40, that with age comes unlovability, that their true inner ugliness will manifest itself unless they drive a syringe full of Botox through its heart.

In interviews, creator Ryan Murphy (a former journalist who once worked for the Los Angeles Times) said what attracted him to the subject of plastic surgery was the idea of human transformation. That might seem to imply that the mutations taking place on the show are mostly voluntary. They’re not. Like vampires or werewolves, the characters on “Nip/Tuck” often resort to plastic surgery not to alter themselves but to halt the mysterious, unwelcome alterations caused by nature. Is it any coincidence the series is set in Miami? Lunar looniness is nothing compared with the ravages of sun. These days, when it comes to eliciting a soul-sucking dread, a clearing in a Bavarian forest, a stark New England town, even the wiley, windy moors have nothing on those sunny, metropolitan, filthy rich spots.

Scary is not a lurching green man in the woods. Scary is your boyfriend trading you for a Lamborghini, as Christian did his ex-girlfriend Kimber (Kelly Carlson) last season. (Kimber is absent from the first three episodes but will resurface later in the season as, eventually, all of “Nip/Tuck’s” repressed do.) In last week’s episode, Sean turned 40 and worried that his best years were behind him. The distress leads him to develop the yips, in the form of a psychologically induced hand tremor. And Julia’s punishing, competitive and disapproving mother, Erica (Richardson’s real-life mother, Vanessa Redgrave), a renowned child psychiatrist who moonlights as an emotional vampire, comes for a visit. Tonight, Famke Jansen makes an appearance as Ava Moore, an aggressively pert life coach whom Sean hires to help Julia. Ava’s first order of business: banishing Erica from Julia’s house, Van Helsing-style. Afterward, Julia has her first orgasm in months.

Before Erica leaves, though, she makes a point. “Children these days are under the same pressure as adults are,” she tells Julia. “Society is constantly pushing them toward perfection -- it’s the parents’ fault, really. All these baby boomers grew up with these high expectations of what life should be. Then they woke up in middle age and became unglued.”

That Libby and her friend decided to blow their heads off because the only people they could think of who “made it” when they were over 30 were Nelson Mandela and Danny Aiello is just the sort of detail that makes “Nip/Tuck” simultaneously so funny and unsettling. Only in the new, improved boomer America would Nelson Mandela and Danny Aiello even belong in the same category -- not to mention at the same party. (P. Diddy, Salman Rushdie and Carson Kressley would also be there.) And only in the new, improved boomer America would not being at that party be taken as proof by some sorry souls that they’d be better off dead.

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‘Nip/Tuck’

Where: FX

When: 10 p.m. Tuesdays

Rating: TV-MA-LSV (may be unsuitable for children under age 17, with advisories for coarse language, suggestive dialogue, sex and violence).

Dylan Walsh...Dr. Sean McNamara

Julian McMahon...Dr. Christian Troy

Joely Richardson...Julia McNamara

John Hensley...Matt McNamara

Roma Maffia...Dr. Liz Winters

Created by Ryan Murphy. Executive producers are Ryan Murphy, Greer Shephard and Michael M. Robin.