This is the latest instalment in the series of books by Irish journalist Paul Howard about fictional irish socialite and narcissist Ross O'Carroll Kelly. The book follows Ross in his trip to the U.S. to reclaim his estranged wife and daughter. The hilarity ensues as Ross is accidentally photographed with a pseudo celebrity in L.A. and gets caught up in a media frenzy and a Z list celebrity lifestyle, including the mandatory nosejob (hence the title of the book). Paul Howard undoubtedly has a unique comic gift and a good ear for dialogue. He conjures up very visceral images through language and contrives some uniquely hilarious, albeit cringeworthy similies (Sorcha's suddenly stood in front of me, with a face like a dick in a bucket of deep heat") but this book is not one of his best. One is left with the impression that this book has been on Howard's backburner for some time now and parts of narrative, which is usually current, feel dated. Howard is also an exceptional social commentator and his books are invariably dripping with satirical humour. This book is no different, his focus this time being our celebrity and image obsessed culture. While the story is kept ticking over nicely and the book is one of those rare few where one feels compelled to read "just a few more pages", the satirical commentary almost becomes a crutch in this book compensating for the frankly uninteresting and under-developed new characters he introduces here. While this book has weaknesses and is far from Howard's best, he is still one of the few authors that can make you laugh out loud and the set pieces in which Ross becomes embroiled in some twisted series of events, invariably of a sexual nature with women, are always hilarious. If you are considering buying this book there are a few things you should bear in mind. This book (along with the rest of the series) has a uniquely Irish twist to it and some people may find the language difficult to understand. Many of the words in the book are spelt as they would sound phonetically in a South Dublin accent and the author frequently uses his own invented form of rhyming slang (Jo Maxi = taxi) and Irish slang words (gaff = house). Also it might be worth reading some of the back catalogue first before reading the latest one in the series as it would help to understand the relationships between hte characters. In summation, while it's not Howard's best it's still better than most.