Someone is vandalizing Christian's possessions, and he attempts to find the culprit. A chemotherapy patient who is considering breast implants brings excitement to Sean's life, and Matt finds himself in a threesome with Vanessa and Riley.

Sean and Christian are reunited with an old friend, Julia bonds with Sofia Lopez, and Christian and Gina clash over their differences in opinion concerning Gina's pregnancy.

As Julia and Sean's daughter Annie faces puberty, they must both face the harsh realization of maturity and deal with their own issues about getting older. When Gina tells Christian he can no longer be involved in Wilbur's life, Christian is forced to reach out to an old flame in order to build a case to gain sole custody of Wilbur.

A man visits with Sean and Christian in order to be given breasts because of the fact his wife lost a breast to cancer. They refuse the job at first, but Liz talks them into doing it. After a while, his wife is overwhelmed with them, and the man wants them taken out, which eventually happens. The wife seems to enjoy them too much, which causes her to question her sexuality.

Kimber has turned to the porn business after impatience caused her to turn back on her acting aspirations. A Real Doll (used for sexual purposes) of Kimber has been made, but Kimber thinks the vagina is too generic, and wants the doctors to fix the doll. Christian blasts the job and tells Sean that it's a bad idea, but Sean wants to follow through because Kimber offered a lot of money, and the practice lost money when Sean and Christian were on the verge of splitting. When Sean takes the doll home to work on it, he gets lost in the moment and has full sex with the doll, which has suction features in the openings to give a full orgasm. Sean realizes how sad he is, but then Kimber shows up to unexpectedly pick up the doll, and ends up having sex with the real Kimber.

Julia has moved into an apartment, and wants to pick up some items from the house to furnish the kitchen, and she also asks Sean if she can spend the weekend with Annie. Sean lets her, despite the fact that he is angry throughout the entire conversation. When Julia shows up the next morning to pick up the waffle iron, she runs into Kimber, who is going to make Sean coffee after their night together. Upset, Julia makes herself over and goes to a bar, where she meets a man she likes. She gets drunk, and winds up in his room where he wants her to use a sex toy on him. She refuses, but then man tries to force her to do it. She makes her way to the bathroom, where she finds a phone and calls Sean, hoping that he will come and get her. She tries to make up with him, but all he does is give her money for a cab and leaves.

Maids and servants of a wealthy woman have a party while she is out of town, and they hire a cheap plastic surgeon to give them all Botox -- Merrill Bobolit. The women all have adverse reactions to it, and one of them comes in to have it fixed because bulges have formed on her forehead. Bobolit has now partnered with Madam Rose, who owns a chain of beauty salons. He performs unsanitary plastic surgery for lower prices in her basement, and they proudly promote this new invented "Bobotox". Christian tries to talk some sense into him, and eventually learns that Merrill is hooked on the anesthesia, and is constantly high on it - even during surgery. Christian acts as his sponsor in an AA-type rehabilitation group. Merrill becomes furious with Christian after a girl he wanted flirts with Christian.

Meanwhile, Matt gets upset at Adrian for wearing his leather coat to school while soliciting drugs to other students. After Adrian refuses to give him the coat back, they get into a fist fight. Since the coat belongs to Matt, the drugs in the pocket are pinned on him. Christian is called in instead of Sean along with Ava, and Ava comes up with the idea to bribe the principal, Ms. Wentworth, with pro bono plastic surgery. After getting off free because of the surgery, Adrian and Matt decide to be friends. While having a conversation in the bathroom at school, Adrian urinates in one of the soap dispensers, and both Matt and Adrian get called to the principal's office again. Sean comes in this time along with Ava, and he forces the truth out of Adrian and Matt, and snaps at Ava. Sean punishes Matt by sentencing him to spending his afternoons at the office doing handiwork and cleaning. Matt realizes he likes spending time there.

Adrian has had the last straw with Ava's harsh treatment, and they share a meaningful moment as mother and son, but it turns weird when they begin to make out.

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.

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 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.

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.

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.

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.

A series of unfortunate events unfold for an unlucky Dawn Budge, who seeks reparative surgery from Sean and Christian. Annie and Eden start to form a sisterly bond, which unnerves Sean.

As Julia's health worsens, Christian falls back into old habits. Sean hires Gina as the new receptionist at McNamara/Troy in order to get back at Christian. Dawn Budge returns to McNamara/Troy after another unfortunate incident which requires cosmetic surgery.

Tragedy strikes the McNamara/Troy family after Julia learns what has caused her ill health. A visitor from Christian's past brings revealing news. Sean finds the price of fame to be more expensive than it's worth.

Sean tries to deal with his feelings for Julia, while Liz and Christian analyze their relationship and Christian meets someone who understands what he is experiencing with his breast cancer.