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.

Sean hires Quentin Costa for six months during Christian's convalescence. The two remove tattoos from a former MS-13 gang banger using cutting edge laser technology. Matt finds Adrian dead in Ava's house when searching for a plane ticket to Paris. The police thinks it's suicide. Julia calls Erica to help Matt deal with questions regarding his sexuality. Christian and Liz operate to repair a scar on the face of a female gorilla, Kiki.

Matt is getting out of control, and Sean, Julia and Christian are trying to find a solution. Quentin and Christian help two students whose faces are glued to the behind of a third student. Christian starts losing interest in the threesome relationship between Kimber, Kit, and himself. He asks Quentin to get involved with Kit to take her off his hands.

A woman wants surgery to make her look like her when she was younger, to jog her Alzheimer-stricken husband's memory. Christian and Sean work on another Carver victim, who does not have the same physical attributes as the other victims.

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.

Seeking fulfillment in his life, Sean becomes a surgeon for the Witness Protection Programme. A man suffering from Body Integrity Identity Disorder (BIID) threatens Christian's life in order to force him to amputate his perfectly healthy leg. Julia, Gina, and Liz develop a new skincare product that uses semen as the main ingredient. They keep the main ingredient a secret though. Joan Rivers is the first to test the product and loves it so much she decides to endorse it.

Sean has feelings for Nikki Moretti. Quentin goes after Julia and she welcomes his attention. Christian has a down-syndrome patient who wants to look like the rest of his family. Christian meets with his birth mother again.

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.

Christian still has second doubts about the wedding. Gina tries to convince Kimber to leave him. Matt's new girlfriend compares plastic surgery to the work of the Nazis.

Sean wants Quentin out of the practice after finding out that he's dating Julia. Christian seems to be ok after Kimber leaving him, but his actions indicate otherwise.

A plane crashes just after take off in Miami. Julia's mother might be one of the passengers. Christian, Sean, Julia and Liz are all trying to save the lives of the people that survived the plane crash.

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.

Christian finds out that Kimber didn't ditch him at the altar but was abducted by the carver. Quentin is a Carver suspect. Julia has bad dreams about her pregnancy. Sean is threatened into doing pro bono work on the transgender woman who was beat up by Matt.

The Carver strikes at a sorority house. His identity is revealed. Ariel's dad kidnaps Matt and Cherry. Ariel's dad forces Matt to make a life threatening decision, while the carver tries desperately to get his last minute revenge. Julia discovers that there might be something wrong with her baby.