Sean and Christian may be celebrating a milestone surgery, but it looks like the future of McNamara/Troy is in jeopardy. Julia tells Sean some devastating news about the baby. Christian decides to redecorate his apartment after a disturbing appointment with his psychiatrist.

Sean and Julia make a big decision regarding their unborn baby. Christian and Sean hit troubled waters with their new boss and begin to realize what it really means to have sold their business. Matt's family doesn't quite get his decision to pursue a new path in his life.

Sean and Julia are looking for a nanny. Sean wants to turn to Christian for support after his hidden desires are revealed. But Chistian is busy going to the gym because he thinks he's too fat.

After having a nipple bitten off by her dog, Shari Noble comes in to have it reconstructed before her husband returns from Iraq. Julia meets a breast-feeding expert. Christian and Liz hit a lesbian bar where Christian tries to attract one of the women there but she's attracted to Liz instead. Sean and Christian meet with a kidney specialist for one of their patients.

Sean soon discovers that Monica Wilder doesn't intend to leave him alone. Christian's therapist has an obsessive torment to reveal. And Burt Landau proposes an unusual solution upon learning that Christian and Michelle are having an affair.

Dawn Budge needs an ear transplant. Burt Landau suffered a stroke and asks Christian and Sean to fix his face.

Mrs. Grubman is back for more Plastic Surgery this time she wants Christian to preform it after she has passed on. Sean and Julia have conflicts over Conor's Surgery.

Liz's new gilfriend, Poppy, wants her to have cosmetic surgery. James makes Christian and Michelle help her steal another kidney. Sean offers consultation to Marlowe, who wants longer legs.

Dr. Merrill Bobolit, who's out of jail, needs Sean's and Christian's professional services. Escobar Gallardo wants them to perform surgery on his face. And Matt tells his family that he's married and that he and his wife are expecting a baby.

It's the year 2026. Conor is getting the whole family together. In the present, Julia and Sean's marriage is at a crossroads.

Even though he doubts his ability to maintain a long term relationship Christian proposes to Michelle and a lonely Sean takes a pathological case for rationalities that have as much to do with himself as with the patient, and James requires to use McNamara/Troy for her own operations.

Sean drinks to a great extent as he spends a depressing Christmas without his family; Christian gets an surprising gift when a 3-year old Wilber comes back into his life; and James pressures Michelle to help as she takes forceful measures to fill her holiday kidney quota.

Sean contrives to sell his portion of the practice; Michelle's connection with James finally ends, but not with James' boss; Gina is not happy to discover about Michelle's role in Wilbur's life; Matt tries to rekindle the spark with Kimber; and Poppy and Liz break up.

Sean considers selling his shares of the practice to Christian and Michelle, although Michelle's past starts to threaten her future with Christian. Meanwhile, Escobar's wife needs cosmetic surgery.