Sean is forced to partner up with a new doctor when Christian begins to deal with the aftermath of his attack by The Carver. The police solicit Sean's help to try and pry loose an obese woman from her own sofa. Meanwhile, Julia decides she can no longer put off making the hard choices about her marriage.
Christian performs surgery on an ape to help add to her chances of finding a male mate. Matt travels deep into his own sexuality after discovering that Ava was a transsexual. Meanwhile, Sean and Quentin face opposition from Christian when they consider removing the tattoos of a gang banger attempting to reform.
Sean, Julia and Christian race to figure out a way to help Matt, who is fast sliding into a sea of troubled behavior. Christian performs a surgery at the house of his old fraternity after a hazing stunt goes seriously wrong. He also, meanwhile, tries to pawn off Kit onto Quentin when the relationship with her and Kimber begins to lose its charm.
Another victim of the Carver comes forward, but Christian suspects that this latest story doesn't add up. An elderly woman hopes extensive plastic surgery will help her Alzheimer's-ridden husband better remember their past. Meanwhile, Sean learns that Matt has petitioned for a restraining order against him with Child Protection Services and that they are looking into the merits of his parental practices.
Christian becomes the police's number one suspect when evidence linking him to the latest Carver victim is found at the crime scene. Meanwhile, an HIV-positive man comes to the office hoping to have surgery that will make him appear healthier.
Christian’s arrest over the Carver case has decimated the McNamara/Troy practice, and Sean and Christian end up involved in the case of a man who has created his own woman from dead body parts. Meanwhile, Julia finds an unlikely business associate in Gina.
Sean tries to put his surgical skills to another use in the Witness Protection Program, leaving Christian to oversee the practice. Christian is immediately faced with the dilemma of whether or not to accommodate a patient with a strange request, one that might not fly with the medical establishment.
Sean isn't sure he is able to put the secrets of Nikki's past behind him and continue on with their relationship. Christian decides to make contact with the mother who put him up for adoption when he takes on a child with Down's Syndrome as a patient. Meanwhile, Quentin is surprised to find his advances on Julia somewhat welcomed.
Christian and Quentin argue over whether or not to attempt a groundbreaking surgery which would give their professional standing a major boost. Christian also bickers with Kimber about quitting the porn business before they get married. Meanwhile, Sean's growing love for Nikki has caused to him to consider going into the Witness Relocation Program alongside her.
As Christian and Kimber's wedding approaches, Christian is hit with concerns over Kimber's forgetfulness in signing a prenuptial agreement. Meanwhile, Matt introduces his new girlfriend to Sean and Christian, but she creates a stir when she likens plastic surgery to the practices of the Nazis.
Sean decides to go all out to get rid of Quentin from the practice when he learns he's been seeing Julia. Christian has trouble coping with the abrupt exodus of Kimber, which begins to manifest itself at work. Meanwhile, Sean learns that several plastic surgery patients have recently become targets of hate crimes and fears that Matt may be involved.
Julia's mother may be one of the passengers on a crashed flight headed to New York from Miami, and Julia, Sean, Christian and Liz are taxed while trying to save as many survivors as they can.
A mall Mrs. Santa comes to McNamara/Troy for a bit of liposuction, but the procedure reveals a secret Mrs. Claus has been keeping from Santa, one which threatens their very union. Meanwhile, Julia must make a choice which will change the relationships within her family forever, and Ariel tries to solicit Matt's help in radically changing her physicality.
Christian gets a disturbing clue from The Carver about why Kimber has vanished on their wedding day. Quentin is pulled in by Detective McGraw as a possible Carver suspect. Meanwhile, Julia begins to have terrible dreams surrounding her pregnancy, and Matt is forced to go to Sean and try and procure free surgical procedures under the threat of arrest for the transgender woman he assaulted.
Detective McGraw gets closer to nailing The Carver, who has maniacally targeted a sorority house. Christian, Sean, Matt and Cherry Peck all somehow find themselves ensconced within a twisted game. Meanwhile, more information on Julia's pregnancy is brought to light.