Nip/Tuck is an Emmy and Golden Globe award-winning American television medical drama series created by Ryan Murphy. (Nip Tuck, 2007) In 2003, the fx television network first aired their hit sit com Nip/Tuck

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Nip/Tuck is an Emmy and Golden Globe award-winning American television medical drama series created by Ryan Murphy. (Nip Tuck, 2007) In 2003, the FX television network first aired their hit sit com Nip/Tuck. Since then the program has set records for most viewed show and have won and been nominated for numerous awards such as 12 Emmy awards and 5 Golden Globes (Nip Tuck, 2007) The television show reached many American homes with ratings well into the millions. The first season alone brought in 3.5 million viewers, and only increased in the years to follow. With ratings this high it was clear this show had America hooked. For the show’s third season, in fall of, Nip/Tuck attracted larger audiences than ever before and set records for the most watched show in FX’s history (Nip Tuck, 2007).

Today, Americans are infatuated with self image. In the business world people are finding it hard to keep up with the up and coming generations unless they have the perfect image. “Age is my biggest enemy and plastic surgery has given me an extension of my business life,” says one realestate agent. Ambition and talent used to be the determinate for a succuessful future in corporate America, “now it seems a quick nip/tuck could be the fastest route to the top” (Pask, 2005, para.5). But this obsession with perfecting self image is not limited to the buisness world alone. It has saturated many american lives. According to an article written by Laura Crane,

Globally beauty today is a US$160-billion-a-year industry. Americans spend more each year on make-up, skin and hair care, fragrances, cosmetic surgery, health clubs and diet pills than they do on education. Cosmetic surgery has become a US$20-million-a-year business, and cosmetic procedures have increased more than 220% since 1997. And while, historically, beauty procedures and treatments were limited to women of the wealthy class, today, more than 70% of those having cosmetic surgery earn less than US$50K per year (Nip Tuck, 2007).

The broad scope of the availability of plastic surgery is shown here. Due to its increasing availability and affordability, cosmetic surgery is enjoying increased attention and acclaim. This high of an interest and importance focused on self-image is no coincidence which can be exemplified by the direct results of the ratings that Nip/tuck has received.

The theme of Nip/Tuck is cosmetic surgery. Figures from the American Society for Aesthetic Plastic Surgery show that cosmetic medical procedures are an increasingly popular industry in America. When Nip/Tuck attracted its 3.7 million viewership in 2003, United States statistics showed that there had been nearly 6.9 million cosmetic and non-surgical procedures in the previous year (Tanne, 2003, para.10). The majority of these procedures involved purely aesthetic physical improvements. The 2 most popular procedures were Botox (an anti-aging procedure) and liposuction which involves sucking out the patient’s fat tissue with a rubber hose (Tanne, 2003, para.10). According to these figures, Americans seem to be increasingly aware of, and interested in self-improvement through plastic surgery.

Due to the increasing demand and exposure that plastic surgery is receiving, the inherent ethical dilemmas and scrutiny of the industry becomes an issue. The media that reflects the industry is also put under a microscope. According to Stoner and Perkins, the mediated text needs to reflect accuracy and consistency in the narrative elements. The narrative elements which become apparent in shows like Nip/Tuck are used to project values through the thoughts and actions of the characters in the show. I argue that Nip/Tuck exemplifies the struggles we all face in society through the values of narcissism and professionalism.

In this paper, I will first describe the show and the plot and characters that serve as narrative elements. I will then show how professionalism and narcissism serve as a contextual basis of importance in today’s society. Next, I will outline the method used to analyze narrative using narrative elements and narrative probability and fidelity. Finally I will analyze Nip/Tuck using its characters and consistencies to prove my thesis.

Description of the Artifact

Nip/Tuck follows the lives of two Miami plastic surgeons, Sean McNamara played by Dylan Walsh and Christian Troy who is played by Julian McMahon. These two doctors run their own practice called McNamara/Troy in south Florida. Sean is a family man who is willing to help anyone who needs it. Sean stays busy with work to distance himself from his dysfunctional home life. His family includes his wife named Julia, two sons Matt, and Conner, and his daughter Annie. Julia is a needy housewife, who is constantly battling her own issues with life making their marriage complicated. Matt is a troubled youth who is always disobeying his parents and getting himself into trouble. Annie, the middle child isn’t a huge roll in the show but she is sometimes thrown in the middle of her parents problems. Lastly the new baby boy who is born with his fingers all stuck together. Having someone in Sean’s family, one of his own blood, who is born with deficiency causes him great anxiety to make him perfect. Sean enjoys helping those who really need it and is always willing to do pro-bono work for just about anyone.

Christian on the other hand is the complete opposite of Sean. He is an “arrogant, narcissistic, unethical, ladies man who worships wine, women, and the all mighty dollar, and will do just about anything to get what he wants (lie, cheat, steal, blackmail and seduce)and has no qualms about practically anything.” (2) Christian is in the business to make ugly people look good, even if they don’t necessarily need it. He is will to give up his body to get whatever it is he wants. He is obsessed with women and women are obsessed with him, although he does not treat them well at all. He objectifies women and is very shallow. In one episode in particular he makes a woman put a brown sack over her head while they have sex. Christian is cold hearted and will do anything to further himself. He is immoral, unethical, and very successful at what he does.

These two men are differing in their values and actions. Christian and Sean represent the popular theme good versus evil. They are constantly arguing about life issue, professional methods, and ethical issues. Sean is the more responsible of the two. One might say that he is the “good guy.” He practices integrity in his profession. He uses his best judgment when making decisions on what jobs he will do for his customers. He encourages people to get corrective surgery rather than aesthetically motivated surgery. Often times he will do pro-bono work out of the goodness of his heart to help those in need. Through Sean’s perfectionist attitude toward life he has become a very successful man. Christian on the other hand in some ways is portrayed the bad guy. He values and glorifies narcissism. He is infatuated with perfection of the human bodies’ appearance.

The whole idea within this story is that you are not ok. At the beginning of each consultation the doctors have, they ask their customers “tell us what you don’t like about yourself.” By asking this question they are suggesting that there is something wrong with you and they need to fix it. This is a reoccurring theme within the story. The show explores the internal struggles of Sean and Christian and what they don’t like about themselves. It points out many of their imperfections and dramatizes those issues.


In 1991 Christopher Lasch explored the comparison of the professional versus the narcissist. In his book he compares the two explaining that a professional shapes his world while, “For the narcissist, the world is a mirror; he cannot live without an admiring audience.” (Lasch, 1991, p. 10) From this book, we see the human need for independence and interdependence and how plastic surgery could have increased potential in coming years. A narcissistic professional could find himself or herself needing admiration and wanting advancement. Plastic Surgery could be the means by which the dependent professional advances in his or her achievement.

Plastic surgery is an increasingly popular medical treatment as well as a professional solution. “Today, more than a quarter of female executives and almost one in five male directors would consider cosmetic surgery to improve their career prospects, according to a survey carried out by The Aziz Corporation, the UK's leading independent executive communications consultancy.” (Pask, 2005, para.6) The conflict between the values of narcissism and professionalism is apparent consistently in each episode of Nip/Tuck. In consultations, patients are often drawn upon by the doctors using a magic marker to identify physical flaws needing correction. The audience understands that each mark made translates to dollar amounts and introspective flaws that may be apparent on the bodies of the viewer as well. In this way, the plastic surgeons promote narcissism. When a patient is finished with the doctor’s assessment they are usually left ridden by pen marks reflecting problems with their physical appearance. These problems are seen as so important that high prices are justified to fix them. Physical imperfections as small as ear corrections can cost as much as $2500 to “fix” (Pask, 2005, para.37). A breast augmentation can cost around $8500 (Pask, 2005, para.37). A more professional option for doctors may be to operate on a woman with enormous breasts which can inhibit her fitness. To reduce her breasts, a $6000 price tag is attached (Pask, 2005, para.37). The reduction would be more professional option and is therefore less expensive. But, one can see how narcissistic motives can conflict and influence a doctor’s influence of a patient’s choice of procedures. Monetarily the doctor would rather perform the breast augmentation where Christian Troy could easily use his magic marker to find several $2500 imperfections to correct and add to the price tag. One PR executive said of her real world plastic surgery, “For me, being a success meant changing something small about myself, and that was a small price to pay.” (Pask, 2005, para.36) For her the procedure was important because her image meant success. The theme of professionalism and narcissism merging together to promote each other becomes increasingly aparent in today’s world.


A narrative is a story that portrays a value or belief. The narrative elements give the story the particular vehicles for communication. The first narrative element is the narrator. The narrator is usually the person telling the story. The second narrative element is the characters. The characters are the “people in the story or things that function like people in the story.” (Stoner & Perkins, 2005, p. 187) The third narrative element is the plot. The plot serves as a patterned connection for the characters to their actions (Stoner & Perkins, 2005, p. 187). The final narrative element is the setting. The setting works as a sort of context that allows us to see the “prior events, circumstances, and conditions surrounding the characters.” (Stoner & Perkins, 2005, p. 187) With these elements, the narrative portrays values and themes through thoughts and actions. The narrator, characters, plot, and setting guide us through the thoughts and actions that the narrative values.

The narrative must ring true. Both in how it is relevant in context, pertinent in the lives of the audience and feasible within its realm. Narrative probability analyses a story’s consistency with the audience and how well the story “hangs together.” (Stoner & Perkins, 2005, p. 191) If the story presents regular values on a reliable basis, the story can be seen as probable. The characters thoughts and actions are important to probability because they must be consistent with what the audience identifies as the values portrayed by each particular character. Christian Troy can be depended upon to be narcissistic while Sean McNamara is consistently professional. Narrative fidelity addresses the audience’s need to find consistency in their own world. There are real plastic surgeons and I will show that for the audience to not see both the professional and narcissistic aspects of the plastic surgery industry represented would be inconsistent. Narrative fidelity reflects this consistency. It compares the real world applications to the story and tests for similarity and relevancy.


Sean McNamara is a skilled plastic surgeon. His character is constantly conflicted by the moral and ethical conflicts that he finds in the plastic surgery field. Despite his success and prestige, Sean is conservative in his behavior. He is attractive aesthetically, but not as concerned with his appearance as his partner Christian Troy.

Christian Troy often uses his position as a plastic surgeon to attract women. He commonly offers them free cosmetic procedures in exchange for companionship and sexual trysts. Christian’s ethics are consistently questionable; both professionally and morally. In the pilot episode, Christian Troy accepts a large amount of money from a drug dealer who is in need of surgery to escape the law.

We see a contrast of the 2 characters’ personalities in the clients they commonly accept. Christian is concerned with dollar value, and has no qualms about accepting more aesthetically driven patients. Sean, in contrast, constantly searches for opportunities to perform pro-bono work. To Sean, the heights of his profession include moral consequences and rewards. In one episode, Sean McNamara wishes to perform a very costly operation on a boy who has been disfigured in a fire. Despite rudeness from the boy’s mother and unavailability of funds, Sean feels remorse and his moral introspection becomes the theme of the episode. We see in contrast, Christian’s indifference and suggestion of another liposuction or breast augmentation to increase profits for the week.

The setting takes place in Miami, Florida; a region known for its image-obsession and plastic surgeon availability. “Miami, Florida, where the weather is hot and the people are hotter. Miami has become the hot spot to find a cosmetic plastic surgeon rivaling Beverly Hills.” (Ienhance, 2007, para.1) The relevance of the setting adds to the shows proof of narrative fidelity. The hot spot for hot plastic surgeons and narcissistic people who feed the industry.

Every surgery is pre-empted by a review of the patients needs in the form of an interview. In every episode, the doctors ask the patient, “Tell us what you don’t like about yourself.” This theme serves as a sort of introspection for both the viewer and the characters in the show. Often, the characters are forced to outwardly contemplate what they do not like about themselves; physically and psychologically. The thoughts and the actions then reflect this introspection to the viewer in the plot. We often see Christian having a physical dilemma. His aging, his body, his sexuality, or his hair all influence different plots and themes to project his values. Christian represents the narcissistic values presented by the plastic surgery industry. The Botox for wrinkle treatment or the breast implants for cosmetic appeal. Sean, on the other hand represents the professional responsibility of plastic surgeons.

Nip/Tuck survives as a medical drama because it is an accurate reflection of reality. The show demonstrates narrative fidelity in it’s portrayal of the plastic surgery business. Dr. James Wells, President of the American Society of Plastic Surgeons, says his Long Beach practice sees about 60% of patients for cosmetic procedures, and 40% of patients for reconstructive surgeries (Tanne, 2003, para.9). In Nip/Tuck, the majority of the surgeries we see the doctors doing seem to be cosmetic as well. The stories that offer themes to each episode, deal with the same ratio. Dr Robert Bernard, president of the American Society for Aesthetic Plastic Surgery, says that “Doctors educate patients. They disabuse patients of unrealistic expectations.” (Tanne, 2003, para.10) Many patients are advised and often refused in the offices of McNamara and Troy because the potential patients are either misinformed, or have unrealistic expectations. Long dialogues typically ensue in the office interview room in which Sean and Christian counsel and educate the patients. At times the counsel is unrealistic to promote the doctor’s confidence in their handiwork. This adds to the narrative fidelity of the story as well as the narrative probability because better doctors do better work.

Nip/Tuck’s creator, Ryan Murphy says, “Our show is a tone piece. It’s pushing the envelope and yet walking a line of drama that I think is very responsible.” (MSNBC, 2004, para.9) The narrator provides a reliable guide to thought and action in the story. The audience can trust the episodes to reflect the struggles of Miami plastic surgeons. “I feel a moral responsibility to show what the suffering is. I don’t want to glamorize it,” (MSNBC, 2004, para.20) Real conjoined twins become part of the cast for an episode in which we see Sean and Christian travel, along with a team of the highest skilled plastic surgeons in the world, to separate the twins (MSNBC, 2004, para.11). For this episode, not only were actual conjoined twins used, but Linda Klein (technical advisor and registered nurse) chose to consult James Bradley (associate professor of plastic surgery at UCLA Medical Center) to ensure authenticity (MSNBC, 2004, para.15). The narrative probability of the show is once again supported by insistence that the episodes reflect real surgeries. The narrative fidelity is confirmed when Professor James Bradley comments that “the surgeries for the most part are accurate, the technical aspect is thought out well, based in fact and reality.” (MSNBC, 2004, para.16) Statements and acclaim from real critics and real doctors solidify Nip/Tuck as a credible medical drama.


Through the actions and thoughts of the plastic surgeon characters; Sean McNamara and Christian Troy, thoughts and actions promote the valued conflict of professionalism and narcissism. Narrative elements such as plot and setting help further the validity of the plastic surgery industry as an exemplification of the common struggle. Nip/Tuck is feasible according to narrative fidelity because it accurately portrays the cosmetic surgery industry. The show passes narrative probability because each show’s values are consistent with the theme. “What don’t you like about yourself,” the doctors continually say during analytical consultations of potential patients. Nip/Tuck reliably explores society’s obsession with self-improvement by way of cosmetic enhancement. The theme song called, “A perfect Lie” sings, “Make me beautiful, perfect soul, perfect mind, perfect face, a perfect life.” As Americans continue to struggle with professionalism and narcissism, Nip/Tuck can be trusted to continually portray these values through the plastic surgeon characters.

Works Cited

Crane, Laura. We're so Vain . Retrieved July 18, 2007, from Med Hunters Web site:

Lasch, C. (1991). The Culture of Narcissism: American Life in an Age of Diminishing Expectations . New York, N.Y.: W. W. Norton & Company, Inc..
Martin, Ed. (2003, July 17). FX's "Nip/Tuck" has critics cheering at TCA. Jack Myers entertainment report, Retrieved July 18, 2007, from (June 17, 2004). ‘Nip/Tuck’ is More Outrageous Than Ever. Retrieved July 18, 2007 from

Nip/Tuck. Retrieved July 19, 2007, Retrieved July 18, 2007 from Answers Web site:
Pask, Rachel. (September, 2005). HEALTH: Nip/tuck your way to the top. Retrieved July 18, 2007, from Where to look for what you need Web site:
Stoner, M. Perkins, S. (2005). Making Sense Of Messages. Boston, MA: Houghton Mifflin

Tanne, J. (August 2, 2003). New US Drama Outrages Plastic Surgeons. Retrieved July 18, 2007,

The Independent , (September 15, 2005). Nip/Tuck Your Way to The Top. Retrieved July 18, 2007, from


Wallace, K.K. (2003). Nip/Tuck. Retrieved July 18, 2007, from IMDB Web site:

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