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 Christian's prized possessions are vandalized, he tries to contact the women he has wronged in the past to find the culprit. In the process, he continues to ponder his behavior towards women in general. Meanwhile, Sean is invigorated after an encounter with a patient, Megan O' Hara (recurring guest star JULIE WARNER), a chiropractor going through a divorce. & Matt's ex-girlfriend, Vanessa Bartholomew (recurring guest star KATE MARA), asks for his help to revitalize her relationship with her new girlfriend, Ridley Lange (recurring guest star SOPHIA BUSH
- " One Tree Hill").
...

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. ...

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. ...

After taking too many painkillers & drinking alcohol, Julia has fallen through a glass door, severely damaging her face. At first, Sean refuses to operate on her, still bitter that she recently went to a rival plastic surgeon & got breast implants. ...