If you feel depressed or lack self-esteem, the obvious solution is -- plastic surgery?

Improving yourself would seem to be an inside-out job: try to figure out what you want; start a class or a hobby; learn a sport; talk to your minister.

When you're really feeling sorry for yourself, volunteer at a hospital or homeless shelter to see beyond the mirror. After counseling, maybe some surgery is part of the answer.

Who knew all that was a waste of time? You can skip the preparation if you turn to the latest trend in reality shows. Extreme makeovers offer doctors, trainers and, best of all, an instantly new you.

I'll stop here to say that plastic surgeons can perform miracles, making it easier for patients to eat, speak, breathe and see. Doctors who repair the injured or burned are heroes. Most people turn to cosmetic surgery to look better, not to turn their lives around. But these TV shows make a mockery of the profession.

Desperate, unhappy people exhibit genuine pain to be chosen for the honor of televised transformation. Men and women cry as they recall childhood slights and insults. The "winner" is the one who exhibits the most self-hatred.

The message is change your face and body and all your problems will be solved. If this were true, Michael Jackson would be the most well-adjusted human being on the planet, and Barbra Streisand would still be saving up for a nose job.

One show promises a reasonable facsimile of a celebrity face for people who don't want to look the best they can, but the best somebody else can. Will success be achieved when someone stops you on the street to ask, "Did anyone ever tell you kind of look like Brad Pitt?"

Fox's "The Swan" unbelievably lives down to its creepy promotional ads. Many of the women competing to enter a beauty contest with other transformed, self-described ugly ducklings look fine, needing maybe some makeup, a new hairstyle and a few trips to the gym. But that would take too long and not be nearly as dramatic as multiple liposuctions, rhinoplasty and chin implants.

Forget about the people who grow more beautiful every time you see them because what's inside shines through.

A woman on the show vows: "I'm going to be a better person." One talks of being abandoned by her father, and you kind of want her to deal with that before wishing for new thighs. Unfortunately, therapy is just an afterthought.

Full-body sketches make surgery look as simple as slicing up a slab of beef. But anything that involves anesthesia and blood and scalpels is going be a lot more complicated or dangerous than a pedicure. It's also going to hurt, as surprised patients eventually discover.

After all her surgery, a tearfully grateful woman stands before a mirror and says that for the first time in her life, "I have real boobs."

For the first time in her life, she doesn't.

The stated purpose of "The Swan" to "transform average women into confident beauties." I hope the confidence lasts at least as long as the fake body parts.