Julia returns to undergraduate school, and strikes up a friendship with one of her fellow students (guest star Phillip Rhys). Christian's plan to seek porn stars as clients backfires. Sean fixes botched surgery on a transgender woman, and discovers he has a personal link to the hack surgeon responsible. Guest starring Sophia Bush and Roma Maffia. An obese woman requests drastic surgery in time for her upcoming high school reunion, leading Christian and Grace to butt heads over her mental state. Julia comes to terms with her parenting after facing criminal charges for flushing Frisky the gerbil down the toilet. Grubman (guest star Ruth Williamson), who threatens McNamara/Troy with a malpractice suit after an accident during her surgery. Christian is forced to play hardball with ageing, widowed socialite Mrs. Sean operates on Matt's botched self-circumcision, while Matt discovers the truth about Vanessa (Kate Mara). Sean and Christian operate on identical twin sisters, who request surgery to look different from one another. Sean tries to encourage Liz (Roma Maffia) to return to work. Matt worries about sex with his girlfriend Vanessa (guest star Kate Mara) and her possible reaction to his foreskin, leading him to self-circumcision. Julia attempts to create direction in her life, and comes to terms with her recent actions. Christian's feelings for Julia begin to affect his sex life.
Grace Santiago, both professionally and personally. McNamara/Troy's new on-site psychologist (guest star Kevin Chamberlin) creates conflict between Sean and Christian, while at the same time Sean grows interested in an independent shrink, Dr. Guest starring Ruth Williamson and Roma Maffia. Aspiring model Kimber (guest star Kelly Carlson), the latest in a long line of Christian's conquests, discovers the ugly truth about his womanizing. Sean's son Matt goes to Christian when requesting a circumcision. Sean's wife Julia struggles at home with her lingering feelings for Christian, stemming from a one-night stand they had together while in college. Julia feels better when she befriends a handsome, flirtatious classmate, however.Best friends since college, Sean McNamara and Christian Troy run a successful plastic surgery practice in Miami, but Christian's unethical acceptance of $300,000 from a mobster desperate for a new face threatens both their friendship and their business. Also, Julia takes classes to pursue her dream of graduating from medical school, but she feels insecure and worthless when she meets her instructor, a longtime college friend who has balanced career and family successfully. He is horrified to learn that the incompetent doctor who performed the procedure was his medical school mentor. Sean's revulsion turns to compassion after listening to the patient's life story. Meanwhile, Sean examines a young transsexual, Sofia Lopez (recurring guest star JONATHAN DEL ARCO), who wants to correct a botched sex-change procedure. Christian brings Matt to a consultation at a porn production, but Matt's subsequent encounter with a young starlet strains Christian's friendship with Julia.
However, the new arrangement causes problems when the practice's more upscale clients become uncomfortable with the office atmosphere.
Christian tries to persuade Sean to go into business with a very successful pornography production company whose performers need cosmetic surgery.
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