Julia's mother wants a facelift and insists that Sean operates on her, which worsens his worry about his hand spasms.

After Christian's nose is broken during sex, he worries about Sean correcting it.

A Somalian woman requests clitoral reconstruction after undergoing genital mutilation. Sean asks Christian for advice regarding an issue with Julia.

Christian finds himself attracted to an alluring blind woman requesting new eyes. After seeing Sean with his new lover, Julia gets breast implants.

After Julia falls through a glass door, she requests for both her scarred face to be fixed, and for her new breast implants to be removed.

Sean must operate on a morbidly obese woman as he searches for a new partner.

Liz and Christian operate on a female gorilla who must have a facial scar removed before she mates.

When Julia's mom comes to visit and to look at Julia's very popular upcoming business, Julia's mom has nothing supportive to say, which made Julia very angry. Julia explodes at her mom telling her to take the next flight out and to stay out of her life. Later that day Julia hears that the plane that her mother took crashed right when it was taking off. Julia rushed to the air port to go see if her mom was one of the only few survivors, she quickly called Sean to come and help look and to help perform surgeries on the passengers who were trying to live. Julia also got to experience some surgeries.

Julia's crafty and controlling mother, Erica, arrives in Los Angeles with her new Italian, boy-toy husband, Renaldo Panettiere, in tow. Shortly after her arrival, Erica announces to Sean and Julia her plans to take both Annie and Conor into her sole custody, manipulating an incarcerated Matt to testify against his dysfunctional parents in the process. Meanwhile, Mike announces his engagement to Kimber, an event which forces both Christian and Kimber to reconsider their own complicated relationship. Liz attempts to fix the situation between her and Christian. Elsewhere, Christian has sex with yet another random woman, Alexis Stone, a bartender who soon reveals that she is a male-to-female transsexual who wishes to undergo surgery to become a man once again.

Christian fields surgical requests from both Alexis who wants enhancements to her trans-gender surgery, as well as Matt's cell mate, Kessler, who wants an unusual favor. Meanwhile, Julia plots to get back at her manipulative mother after years of emotional abuse. While Sean and Julia try to form a united front for custody of Annie and Connor, Erica learns troubling details about her new Italian husband, Renaldo, who is not only a gigolo but a pervert.