• by May 20, 2017

“So tell me, what’s been going on in your buttock area?”

You have to admit that’s a pretty good opener for a patient exam on “Botched,” a reality show about cosmetic repair work that kicks off its fourth season on E! on June 18.

The buttock line comes from plastic surgeon/ “Real Housewives of Orange County” husband Dr. Terry Dubrow.  He’s an old hand at both being the on-air talent and the behind-the-scenes worker-scalpel, cranking out the bottomless cosmetic work required for becoming a reality star in the first place.

Such is the self-fulfilling loop and incestuous, evil/brilliant concept of “Botched.”

Dubrow is joined on-camera by fellow surgeon Dr. Paul Nassif, who also served his time as a Bravolebrity, as the (now-ex) husband of a former Real Housewife of Beverly Hills.

They’re a tag team of entertainers, in which Nassif remakes the unfortunate noses and Dubrow redoes the botched boob jobs. At times, the show also serves as a family reunion for down-and-out reality peeps from all networks with bad face work and severe camera-dependency issues.

Among the recycled former reality stars still seeking the 15 minutes was Farrah Abraham, who came into the spotlight on MTV’s “16 and Pregnant” and then went on to amp up her face and body many times while attempting a career in porn. She came in for botched lip implants.

We also got to see TLC’s Mama June, aka mom to Honey Boo Boo, who, while explaining her hanging-skin stomach situation, revealed the fascinating (fake?) fact that during the Caesarian section that brought Boo-Boo into the world, the surgeon mistakenly sliced into the baby’s head, twice.

She’s off-the-air due to her romance with an alleged child molester.  But the no-longer-obese mom is just one of many reality stars proving that regardless of facing the ignominy of bankruptcy, divorce, and/or prison that seems to come with the genre, these performers just can’t go straight.

But back to “Botched.” Who knew that some of these eye, nose, lip,boob, and fat removal procedures require constant retooling, or that they could go so wrong?

Each episode features three different patient stories, and the premiere of the latest season attempts to offer a blend of humanity and diversity, but goes heaviest on sheer, unadulterated freak show.

First in the lineup is Flame, a female impersonator (“Dad by day, drag queen by night”) with sole custody of his three kids. He’s seeking repairs for his leaky, hanging old breast implants, his third set that he got on the cheap in Mexico.

Dubrow tells the camera that “it used to be considered bad practice to give a male female breast implants,” but in the last few years, “all that has changed.”
Flame gets his “double-bubble deformity” fixed, and indeed, he has a winning personality and goes back on stage with a great-looking rack.

Then we get a young woman, a civilian in the reality wars, with more standard hanging tip and breathing issues, in need of a nose repair. (Meh.)

The third story brings on the freak portion in neon: Martina Big has “the biggest boobs in Europe,” she brags, and wants a rear end to match. (Shades of Kim Kardashian, Patient Zero in this burgeoning reality/body deformity ecosystem.)

It’s never clear what Ms. Big and her boyfriend/manager actually do, or how sane they are. But they are like German cartoon people, with matching platinum hair and accents.  She has a permanent port in her chest to keep her boobs blown up (nine pounds each, she claims) and has had so much liposuction on her legs that her rear ended up looking stunted.

She and her boyfriend act out for the cameras at home, filling up preposterous water balloons and placing them inside her “pents” to pump up her back seat.

In the end, after using Big as ratings catnip, Dubrow tells Big that it’s not gonna work. Even reality impresarios have their limits, I guess. And the bizarre Ms. Big got her jones fed.

Indeed, in this genre, the more outrageous you are, the more camera time you get. And the more camera time you get, the more cosmetic surgery you are primed for.

It’s a loop inside a loop: Obviously, the rejuvenation on this show comes with lots of risk and pain, never shown. But enduring the knife has become part of the whole reality performance art.

The key line in this premiere episode comes from Ms. Big herself, when she learns that she can’t receive the enormous butt implants of her dreams: “The fantasy is not real.”

Maybe with the death of Barnum & Bailey, the reality genre, having spat out everyone from porn stars to presidents, is our new, three-ringed circus. And watching “Botched” is the show within the really big show, like getting inside the engine room.

Indeed, the fantasy is not real. We are all exhibitionists and voyeurs. And I wish I could look away.