Candy Richards, the washed-up, narcissistic actress returns wanting butt implants to make her more African-American for her re-discovered roots. Meanwhile, Christian meets a feisty, chain-smoking lady named Roxy St. James at a cancer support group who asks him to perform a mastectomy to reduce the probability of her developing breast cancer. Sean becomes troubled when Olivia wants a full makeover for herself as she and Julia are planning to move back east. Olivia (unknown to everyone) is emotionally stressed to her breaking point after covering up her psycho daughter Eden's murder attempt on Julia. But it naturally all turns out bad... even for the innocent and the evil alike.

Christian and Sean struggle to keep their business thriving in a failing economy, and enlist another surgeon to attain additional income.

Sean is hit with an ethical and moral dilemma when he is offered a deal. In return for performing liposuction on an obese prisoner about to be executed, Matt would being released from prison. Christian, after discovering that Kimber is pregnant, orders her to have an abortion or lose him in the process. He does not want any more children. His issues an ultimatum when he promises to marry her if she goes through with the abortion. A desperate Kimber turns to both Liz and Mike for advice while deciding how far she is prepared to go for the man she loves. Also, Matt discovers information that could jeopardize his possible release from prison.

Kimber grows frustrated by changes in Christian's physical appearance and his lack of respect for her new career, pushing her into the arms of her newest interior design client: Sean. Meanwhile, Christian refuses to operate on a former supermodel named Willow Banks, who wants to surgically alter her face in an effort to look ordinary. Also, Sean operates on Rupert Kenney, a survivor of an 18-year coma who wants to both look and feel like his younger self.