Beauty is a curse on the world. It keeps us from seeing who the real monsters are.

Another victim of the Carver shows up to have his face fixed - this time it is a male, who was both raped and carved. They agree to fix him. A local news station does an interview with Sean about the pro bono work on Carver victims. The Carver finds his way into Sean's home. After Sean gets out of the shower, the Carver drugs him up and has a conversation with him. He slices his right cheek, and tells him that if he fixes another one of his "masterpieces", he is going to kill him. Julia helps him recover, and Sean tries to win her back - but she reminds him that she is happy with Kevin.

Meanwhile, Gina tells Christian that she is HIV positive, meaning that Christian may be also. He calls his past lovers, including Manya, Erica, and Grace. He visits Kimber on the set of a porn movie, which she is directing. She tells him that she got tested quite recently because she's in the business, and that she's clean, which slightly relieves Christian. He has one more call to make - James and Wilbur (now known as Gabriel). They both come to visit, and Christian becomes very emotional. Christian's tests come back negative, and he visits Gina in the hospital with the good news. He lies down next to her in her hospital bed after a heartwarming conversation, and they fall asleep together.

Joan Rivers consults with Sean and Christian to have all of her plastic surgeries undone, because she wants her grandson Cooper to learn that you don't have to be perfect. When she ultimately learns what she will turn out like after the work has been finished, she decides to give up on her original plan and asks the doctors to schedule her for a facelift the next morning. Matt is concerned about Ava, who seems obviously depressed. He suggests they go away to Paris and start a new life together, which she reluctantly accepts after some convincing. Matt goes to McNamara-Troy to steal drugs for her to take with them. Christian finds him, and gets upset when he learns Matt is going to Paris. Christian goes to have a talk with Ava, and when trying to make a point using sex, he learns that Ava is really a transsexual. Julia, Sean, and Christian spend the night researching, and trace their way to Maryland and a Gender Reassignment center.

After Christian's Carver attack, Sean must look for a new partner to keep the practice going. Sean has to surgically separate an obese woman from a couch she has spent the past three years on. Julia realizes that she has to make a decision about the future of her marriage.