Plastic surgery is all the rage, on the television set and in real life. Reality shows like ABC's "Extreme Makeover" and Fox's "The Swan" have made this plaything of the beauty-obsessed rich seem like a middle-class craze. But plastic surgeons have also been fictionalized, in a ridiculous and overwrought way, on the FX cable channel's shock-drama "Nip/Tuck."

The show's creator, Ryan Murphy, has declared that it is his goal in life to remove every barrier to depiction of explicit sex on over-the-air TV. He was quoted earlier this year saying, "It's tough to get that sexual point of view across on television. Hopefully I have made it possible for somebody on broadcast television to do a rear-entry scene in three years. Maybe that will be my legacy."

"Nip/Tuck" arrived on the cable scene last year with a sickening bang. Critics might call it a melodrama. But it's never mellow. It's a hyper-drama. It revolves around graphic sex, a surfeit of nudity and screaming-orgasm acting. It features routine obscene language, with no bleeps. In addition to beatings, killing, and torture, it favors gut-churning, graphic operation scenes that make the most graphic "CSI" look like a calm episode of "Mr. Wizard."

Since it debuted in late June, the second season of "Nip/Tuck" is, if anything, trying to make its first season look mildly boring. This show doesn't produce the gritty realism that TV critics love to promote. It goes preposterously over the top in an attempt not to push the envelope, but to shred it. (And that's something else the TV critics love to promote.)

FX loves listing all of the critical raves. "Cable's most addictive show," declares In Touch magazine. It's an "amazing slice of life," gushes Us magazine. It "pulls no punches," says the New York Daily news. It's the "Coolest Show on TV," boasted TV Guide.

The show's center of "cool" is good-looking Dr. Christian Troy. Guess which of these scenes is so wild it didn't air on this basic-cable television show (available in most American households):

1. The show's star giving in to an occasional girlfriend's demand that he "nurse" the milk from her breasts to avoid staining her shirt ; the scene featured an obscenity-laden argument and ended by showing Dr. Troy spitting the breast milk into the sink.

2. Dr. Troy breaking his nose while performing oral sex on a woman who sneezed during the encounter.

3. An African woman with a female circumcision having sex with Dr. Troy to see if her newly reconstructed genitals "work"; accompanied by a scene depicting her masturbating.

While you ponder those options, consider which of these three other plots is just too ridiculous for even FX's audience to witness:

1. Matt, a teenaged boy, having sex with his middle aged "life coach." Her own teenaged son is aware of it, sees them in bed together, and is asked to help hide the affair from Matt's parents.

2. In a crazed attempt to conceive a pregnancy, a character has sex with at least four different men in a very short span of time, complete with nudity and graphic visuals.

3. An episode about a pre-teen girl starting puberty with a celebration involving a woman telling a gathering of girls a story about 'Princess Menses' going on a date that ends with the line: "'Take off your clothes, Princess,' said the prince. Pressing up against him, the princess felt a hard bulge..."

If you're familiar with "Nip/Tuck," you know the answer. None of these plots is too ridiculous. They all unfolded on prime-time cable TV.

The outrages are not all sexual, or violent. It shouldn't be surprising that creators of a show like this have utter disdain for religion. In one August episode, a woman comes for plastic surgery after having stigmata in her feet, which she told a Catholic parish were miracles from her faith in Jesus. The Catholics are amazed by this "miracle," but she suggests to the surgeons it was all a fraud put across by the nun running the Catholic parish so the diocese wouldn't close down her programs. She declares near the show's end: "Don't you get it? There's nothing to believe in any more."

If Ryan Murphy is correct, and this is the direction "cool" TV is going, if this is "the future," then where will Hollywood stop? Where is the bottom of the barrel located, or is our desire for "fabulously lurid" entertainment a bottomless pit of nihilism? "Nip/Tuck" is not just a show that's completely inappropriate for impressionable children to watch. It's a show adults should be convincing other adults not to support. The sanity of our popular culture depends on our objections.

And you can thank Toyota, Coca-Cola, Victoria's Secret, and especially the enthusiasts at XM Satellite Radio for sponsoring this garbage for us.

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 Write to Brent Bozell