In the season finale, drug lord Escobar Gallardo's (recurring guest star ROBERT La SARDO) demands that Sean & Christian perform free breast implant removal operations on women Escobar uses to smuggle liquid heroin into the United States nearly force Mc Namara/ Troy into financial ruin. But the loss of potential patients to the surgeons' rival, Merrill Bobolit (recurring guest star JOEY SLOTNICK), is especially stinging to Christian. When he confronts Bobolit about falsely advertising Kimber's (recurring guest star KELLY CARLSON) surgery as Bobolit's work, Christian learns that his former girlfriend is now engaged to the prosperous Bobolit, & the couple is determined to ruin Mc Namara/ Troy. Meanwhile, Sean's troubles at home worsen, & he & Julia move closer to divorce. Christian goes to Julia, explains the situation that he & Sean are in & confesses blame, begging Julia to stand by Sean. ...

At Sean's insistence, Christian agrees to hire a staff psychologist. However, the male candidate they choose is no more ethical than Christian. As Sean & Julia continue having trouble in their marriage, teenager Matt asks Christian for help getting a circumcision to please Matt's girlfriend. Sean & Christian meet gorgeous identical twins who want to change their features in order to establish unique identities. Meanwhile, Sean becomes attracted to the twins' psychologist, Dr. Grace Santiago (new series star VALERIE CRUZ). Christian offers to watch over Julia while she & Sean are separated--but, unbeknownst to Sean, Christian has his own agenda with Julia. ...

Christian becomes furious when Sean agrees with Grace, who is now the practice's in-house psychologist, regarding a woman's desire for extensive surgery in order to look beautiful for her high school reunion. However, Christian later realizes that Grace may have been right about the patient's mental stability. Meanwhile, after finding Matt dazed & bleeding from attempting a self-circumcision, Sean agrees to perform the procedure properly & prevent permanent damage. But Sean is unable to operate on his son, so Christian does the surgery in exchange for Sean taking Christian's most demanding patient. Sean's nervousness results in an oversight that forces Christian to make an unsavory deal to save the practice. & Julia is ordered to attend anger management classes when she is reported to animal services for flushing Annie's pet gerbil down the toilet. ...

Sean & Christian interview a potential patient, a Caucasian man who wants his eyes to look Asian so he can be accepted by his fiancée's family. Meanwhile, Sean suspects domestic abuse when he notices old scar tissue on a patient while performing a nose job. & Julia must choose between medical school & motherhood again when she discovers that she is pregnant. ...

When Julia surprises Matt having sex with both Vanessa Bartholomew (recurring guest star KATE MARA) & Ridley Lange (recurring guest star SOPHIA BUSH), she humiliates him by demanding an intervention with Ridley's nonplussed mother & Vanessa's outraged parents, who didn't even know that Vanessa is a lesbian. Julia also clashes with Sean regarding how to parent Matt, but Matt appreciates his father's support. Following Sean's advice, Matt forms a stronger friendship with Vanessa, even though she cannot love him. ...

While driving his friend Henry (recurring guest star ANDREW LEEDS) home, Matt looks away from the road & strikes a shy girl, Cara Fitzgerald, throwing her out of sight into a ditch. Disoriented & worried because there is marijuana in the car, the boys don't realize that they've hit a pedestrian & leave the deserted area. But later, Matt learns that Cara is hospitalized in a coma. ...

Christian accompanies his sexy girlfriend, Kimber Henry (recurring guest star KELLY CARLSON), to a spa where they encounter rival plastic surgeon Merrill Bobolit (recurring guest star JOEY SLOTNICK). Eager to break up with the clingy Kimber, Christian agrees to a hideous deal, trading her for Bobolit's Lamborghini sports car. The men concoct a manipulative scheme to bring Kimber & Bobolit together, but she later finds out the truth & gets revenge on Christian during rough sex play. ...

As Sean reluctantly celebrates his 40th birthday, Christian urges him to take advantage of some of the youth-preserving treatments available at the clinic. But Sean vows to grow old naturally. Much more upsetting, however, are the occasional muscle spasms that Sean experiences during delicate surgery, prompting him to visit a neurologist. ...