When Sean and Christian win a prestigious award from their alma mater, Sean recalls their college years and endures past pains. A new patient who self-mutilates due to a genetic disorder comes to McNamara/Troy for reconstructive surgery.

Following a failed suicide attempt, a new patient seeks facial reconstructive surgery. Christian tries a risky maneuver with Kimber to heighten their marital passion. Sean performs pro-bono surgery with a charitable surgeon and former college friend in an attempt to quell his guilty conscious.

Christian has a crisis of conscience when Kimber's mother Brandy visits Los Angeles. Complications arise as Sean prepares for his trip to Africa. A patient requires multiple cosmetic procedures after suffering an attack by a wild animal.