Cosmetic surgery: Jean Nouvel remodels Madrid's Reina Sofia Museum with characteristic vigour.

Like a gaggle of well heeled, well upholstered femmes d'un certain age, the venerable institutions of Madrid's Museums Mile are all having a bit of work done. Their cosmeticians of choice range from Rafael Moneo, who is discreetly and soothingly fussing around the grande dame of the Prado, to Swiss clinicians Herzog & de Meuron, who propose more radical surgery for the Fundacio La Caixa. First to be unveiled, however, is Jean Nouvel's addition to the Museo Reina Sofia, Spain's national modern art museum and repository of Picasso's Guernica. With its hovering, tongue-like roof and viscerally red skin, Nouvel's new building certainly racks up the shock value, like a huge flayed organism bleeding and glistening in the Madrid sun. It is also unashamedly monumental, an architecture of engorgement and enhancement that toys, in an almost Frankensteinian way, with scale and proportion. Like its architect, it is no shrinking violet.

Though the mad genius persona is perhaps wearing a bit thin, Nouvel's early oeuvre, a stylish, subversive version of High-Tech, had a genuinely iconoclastic streak at a time when his British counterparts were still earnestly fiddling around with yacht details. Now he is older and more big league, the charming Gallic subversiveness is beginning to coarsen into parody. Certain signature forms (the tongue-like roof, the phallic tower) are paraded with predictable regularity, like the hucksterish repetition of slightly lame jokes. Yet after years of inactivity on the Iberian peninsula, he is suddenly Spain's architecte du jour. Last year witnessed the completion not only of Reina Sofia, but also the Torre Agbar in Barcelona, a meaty, mighty, multicoloured phallus that looms over the city with flagrant abandon. These are major projects that test his ideas in new and challenging contexts. How, then, does Reina Sofia measure up?

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Though perhaps not quite prepared for the scale and intensity of Nouvel's madcap overtures, historically, Reina Sofia is no stranger to the odd bit of inventive nip and tuck. In the late '80s, Ian Ritchie was commissioned to add a series of elegant, free-standing lift towers in steel and glass (AR December 1991). Offering fluid views of the city, their gossamer-wing presences impinged very lightly on and made an evocative contrast with the rather static existing building. First built as a hospital in the latter part of the eighteenth century, to a stolid Neo-Classical design by Francisco Sabatini, its ponderous bulk is penetrated by a central cloistered courtyard, now a luxuriant garden that offers welcome respite from Madrid's scorching heat. Modified and added to over time, it fell into disuse in 1965, and despite being never that popular; managed to survive demands for its demolition. In 1977 it was eventually declared a historic monument and in 1986 was reborn as the Centro de Arte Reina Sofia (now Museo Nacional de Arte Reina Sofia), Spain's national museum of modern, avant garde and contemporary art with a collection that includes work by Dali, Picasso, Chillida and Tapies, among others.

Growing visitor numbers (between 1994 and 2004 doubling to around 1.45 million annually) allied to the need for more space were familiar catalysts for a 1999 competition to find an architect who could design and deliver a sizeable new extension. Nouvel's scheme was preferred from a shortlist of 12 that included Zaha Hadid, David Chipperfield, Tadao Ando and Dominique Perrault. His new complex occupies a roughly wedge-shaped plot on the south-west edge of the Sabatini building. Hemmed in on three sides and facing the blaring main drag of Ronda de Atocha on the fourth, it is a tight, inhospitable urban condition.

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Nouvel's building turns its back on this civic anomie and focuses hermetically inwards, reinterpreting the archetypal form of the old hospital with its secluded cloister. New exhibition spaces, a library, auditorium and restaurant are arranged around an imposing internal courtyard and yoked together by the balefully hovering plane of the big roof. Funnel-like openings emphasise its depth and admit light with an almost Piranesian intensity, the general effect as oppressive as it is dramatic. Part of Nouvel's difficulty is that many of the volumes (galleries, auditorium and to some extent the library) are essentially blind boxes that suck life out of the courtyard. Initial competition drawings depicted a softening cluster of existing trees in its midst, but in practice nature has been overcome by artifice and the result is a somewhat Stygian void (despite the adjacency of a cafe and bookshop), that only serves to dwarf and overwhelm its ant-like users.

Possibly the most fully resolved space is the timber-lined, multi-storey cavern of the library, which runs along the main facade of Ronda de Atocha. Softly glowing bookstacks enclose a quintuple height void which is audaciously crowned by a Chareau-goes-disco ceiling canopy of glittering glass blocks. The circuit of foyer and promenading volumes that weave around the two auditoria, exposed like gelatinously gleaming body parts, are also more successful in experiential terms, with changing views and a greater sense of intimacy. So too are the terraces at the building's topmost level where Nouvel pulls away a floor to create a void under the lowering roof, a move that helps to ventilate the courtyard, as well as create a set of informal, al fresco spaces for display (both cultural and social). Enclosed by the most ethereal of glass balustrades, they offer, like Ritchie's lift towers, uplifting vistas of the city, replayed and reflected in the underside of the roof, and it must be hoped that they will be put to imaginative use by the museum's management.

At its north corner, cemented by a knuckle of circulation, the new building connects through to Sabatini's hospital, but in general, new nudges up against old with as much tact and dignity as two passengers squashed together on a crowded train. Tapering from its depth over the courtyard, the roof slims down to a blade-like edge that seems to be actively menacing the old building. The floating roof is clearly reprised from the Lucerne Cultural Centre (AR October 1998), but whereas Lucerne is an object building on a lakeside plot, Reina Sofia has to contend with a less forgiving urban condition and in the context of its impassive neighbours and tight site, ends up looking hectically gestural. There are also issues of constructional finesse. As might be expected, the Swiss effortlessly rose to the challenge in Lucerne, but the complexities of Nouvel's form making and detailing have, at times, proved beyond the Spanish and there are some uncomfortable gear changes.

Though Reina Sofia must rate as a disappointing individual setpiece, it does provide the museum with new sorts of spaces with which to extend its cultural agenda. And as it is the first in a series of superstar interventions, it should perhaps be re-evaluated as part of a wider urban conversation when the other ladies of Museum Mile finally complete their makeovers. Meanwhile Nouvel watchers will be hoping for a return to form with the completion of the eagerly anticipated Ethnographic Museum at the Quai Branly in Paris later this year.

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