Two recurring characters are introduced in an episode that teaches the odd-couple plastic surgeons a few lessons about moral boundaries. Patti D'Arbanville plays Wallis Forsythe, a pornography mogul who meets Christian at a party and agrees to send some business his way. And Joey Slotnick plays Merrill Bobolit, a hack surgeon who's more successful than Sean and Christian because of his willingness to take on any client. Forsythe's easy money and Bobolit's sleazy competition inject a dose of conflict into Sean and Christian's partnership--as if it needed any more of it!

Sean and Jude's respective secrets are revealed, and Merril offers Christian an interesting trade: Kimber for a Lamborghini. Christian accepts, but Kimber discovers the truth and exacts a small revenge.

Sex gone wrong causes Christian to break his nose, but Christian is worried that Sean's medical condition will keep him from performing the corrective surgery. He consults a rival (female) plastic surgeon across town. Christian and Gina have sex, but she gets upset when Christian tells her that he's imagining the female plastic surgeon instead of her. Gina tells him that he looks hideous, so Christian decides to operate on his nose himself, which goes terribly wrong. Christian, trying to show that the McNamara-Troy partnership is worth something, tells Sean that he wants him to fix his nose. When Sean panics, Christian decides to go through the surgery without anesthesia, so they can do it together. Sean performs the surgery successfully. Meanwhile, Matt learns that Harry has been arrested for raping Cara Fitzgerald, and that Harry has told the authorities about the hit-and-run, and that Matt was involved. While under oath, Matt says that he had no involvement with the car accident.

When local model Naomi Gaines is raped & disfigured by an attacker named "The Carver", Sean decides to repair her injuries on a pro-bono basis, thrusting McNamara/Troy into the local media spotlight, trying to overcome the slander caused by Bobbie Broderick. After getting caught sneaking into the house late at night, Matt lies by telling his parents he was studying with Ava's son Adrian. Adrian is forced to play along with the subject when Julia invites them all to dinner. Adrian reveals Matt & Ava's relationship, causing Julia to lash out at Ava & Matt. When Matt becomes uncomfortable with his increasingly demanding relationship with Ava, she reveals to him the secret that his mother is keeping from him.

Maids and servants of a wealthy woman have a party while she is out of town, and they hire a cheap plastic surgeon to give them all Botox -- Merrill Bobolit. The women all have adverse reactions to it, and one of them comes in to have it fixed because bulges have formed on her forehead. Bobolit has now partnered with Madam Rose, who owns a chain of beauty salons. He performs unsanitary plastic surgery for lower prices in her basement, and they proudly promote this new invented "Bobotox". Christian tries to talk some sense into him, and eventually learns that Merrill is hooked on the anesthesia, and is constantly high on it - even during surgery. Christian acts as his sponsor in an AA-type rehabilitation group. Merrill becomes furious with Christian after a girl he wanted flirts with Christian.

Meanwhile, Matt gets upset at Adrian for wearing his leather coat to school while soliciting drugs to other students. After Adrian refuses to give him the coat back, they get into a fist fight. Since the coat belongs to Matt, the drugs in the pocket are pinned on him. Christian is called in instead of Sean along with Ava, and Ava comes up with the idea to bribe the principal, Ms. Wentworth, with pro bono plastic surgery. After getting off free because of the surgery, Adrian and Matt decide to be friends. While having a conversation in the bathroom at school, Adrian urinates in one of the soap dispensers, and both Matt and Adrian get called to the principal's office again. Sean comes in this time along with Ava, and he forces the truth out of Adrian and Matt, and snaps at Ava. Sean punishes Matt by sentencing him to spending his afternoons at the office doing handiwork and cleaning. Matt realizes he likes spending time there.

Adrian has had the last straw with Ava's harsh treatment, and they share a meaningful moment as mother and son, but it turns weird when they begin to make out.

Rhea Reynolds is found dead (apparently murdered by the carver). Christian is the prime suspect. A man with a very hollow face (caused by the HIV medication that he's taking) is this episode's patient.

Christian and Quentin disagree over the ethics of an extremely dangerous operation that would enhance their medical reputations. Sean is thinking about giving up everything and disappearing into the Witness Protection Program with Nikki and her son.

Sean and Christian are perform a mico-liposuction on Joy Kringle, a woman who acts as Mrs. Claus during the Christmas season. During her lipo they find a seventeen year old fetus inside her. Julia is not feeling well. A blood test performed by Sean reveals why. She is pregnant.

Sean soon discovers that Monica Wilder doesn't intend to leave him alone. Christian's therapist has an obsessive torment to reveal. And Burt Landau proposes an unusual solution upon learning that Christian and Michelle are having an affair.

Even though he doubts his ability to maintain a long term relationship Christian proposes to Michelle and a lonely Sean takes a pathological case for rationalities that have as much to do with himself as with the patient, and James requires to use McNamara/Troy for her own operations.

A patient inspires Sean to take his relationship with Kate in a new direction. Eden uses extreme methods to persuade Christian to perform surgery on a friend. Kimber reaches out to an former business associate when she and Matt fall on hard times.

Sean experiences the ugly side of Hollywood in the form of a television critic. Matt experiences a special bond with one of Christian's patients. The cause of Julia's ailing health is discovered.

Christian decides to employ Dr. Logan Taper for the practice, while Sean is revisited by a former client from Miami to have plastic surgery so she can attract suitors once her husband dies.