Шон навършва 40 години. Забелязва, че тялото му е остаряло. Нервен тик по време на операция заплашва да сложи край на кариерата му като хирург. Появява се майката на Джулия. Ерика е известна писателка-психоложка, която години наред е впечатлявала с перфектната си външност, но годините са си казали думата. За да си върне предишния дух и самочувствие, тя настоява за козметична операция.

Sean se enfrenta a la crisis de los 40 y se da cuenta de que no siempre es posible retroceder en en tiempo. Entretanto, Christian intentará equilibrar su promiscuo estilo de vida con la paternidad. Además, la suegra de Sean quiere hacerse un liffting.

Sean has just turned 40, and he is already noticing it. His body is aging, and he has developed "the yips", making his performance during surgeries decline. Julia breaks the news to Sean that her mother, Erica, is coming to visit. Erica tells them that she wants a facelift - and she wants Sean to do it. Sean would prefer that Christian do it instead. Meanwhile, Christian is having problems with picky Gina, who is trying to keep Christian away from baby Wilbur, because it isn't his baby. Having his own problems with age, he is rejected by a 25-year old at a bar. Christian decides to hire a nanny, who he ends up having sex with, and later learns that she is giving the baby drugs to keep it from crying. Christian tries to convince Sean to have botox, but he refuses (at first). They perform surgery on a woman who was shot in the face nine months earlier. She is brought along by her gay friend. The two are having problems because the woman loves Chad, but Chad doesn't love her in that way, because he's in love with his boyfriend. We learn that Chad and the woman were planning on shooting each other, but she couldn't pull the trigger, so Chad was left unharmed.

During Erica's facelift, Sean panics and can't do it. Christian is having some trouble too - he's slept with Erica, the night of Sean and Julia's wedding. The surgery continues. Later that day, Christian is having problems with Wilbur, so he calls Julia to come help him. She gets upset on how Christian can't handle his own responsibilities, and snaps at him for sleeping with her mother.

Sean compie 40 anni. La sera della festa di compleanno si accorge di un piccolo tremito alla mano. La madre di Julia, Erica, si presenta a casa McNamara con un'insolita richiesta: vuole sottoporsi ad un intervento per riguadagnare il sex appeal. Una donna è rimasta sfigurata dopo che il suo tentativo di suicidio non è andato a buon fine. L'accompagna un amico gay.

Le Dr Sean McNamara célèbre son 40ème anniversaire. Devant le temps qui passe, son ami Christian tente de le convaincre d'agir, et de passer à son tour sur la table d'opération. L'occasion aussi de régler son problème de tic nerveux qui survient lors d'opérations délicates. Christian, pour sa part, accepte d'aider Gina Russo et son enfant. Anciennement amants, et même s'il n'est pas le père du bébé, il se met petit à petit dans la peau d'un papa. Mais quand la mère de Julia, Erica Noughton apparaît dans leur vie par surprise, tout se complique. Cette femme égocentrique et très envahissante veut absolument paraître plus jeune...

Sean 40 éves lesz, és már észre is veszi magán. A teste idősödik, és a műtőben a teljesítménye is megkopott. Julia közli a hírt Sean-nal, hogy édesanyja, Erica, eljön meglátogatni őket. Erica elmondja nekik, hogy egy arcfelvarrást akar - és azt akarja Sean csinálja meg neki. Sean jobban szeretné, hogy Christian csinálja meg helyette. Mindeközben Christian-nak egyre több problémája van Gina-val, aki próbálja távol tartani Christian-t babájától, Wilbur-től, mivel nem az ő gyermeke.