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

Sean and Julia are shocked when Annie enters early puberty. Mrs. Grubman returns, requesting a knee lift.

A middle-aged woman requests liposuction in order to compete with younger women for her dream job of selling clothes.

While Sean operates on a model who was raped and scarred by a serial killer, an unsatisfied patient sets out to destroy his reputation.

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.

Christian discovers that his former rival has been working as a cheap plastic surgeon and performing dangerous operations on desperate patients.

Sean and Christian must fix the nose of an abused housewife, whose husband is in prison for killing their child.

Comedian Joan Rivers comes in requesting all of her previous plastic surgeries to be undone.

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

Julia visits Sean and Christian in Los Angeles to share some life-changing news, and she also rejects romantic advances from both men. Meanwhile, Matt gets a blast from his past when Ava Moore, who caused immeasurable family chaos years ago, turns up as Matt prepares to marry Ramona. Also, Liz reveals that she's happily pregnant.

In the series finale, Christian agrees with Ava to operate on baby Raphael in exchange for her to stay out of Matt's life who has abandoned everyone to be with Ava. While preparing to leave for London, Julia worries about Sean's mental state of mind as he continues to be in denial about his feelings of abandonment. Liz is overwhelmed by Sean's excitement over her pregnancy when he adds her name to the practice and sets up a nursery at the office. Christian's worry about Julia moving far away, and a vision of the deceased Kimber forces him to reconsider his long-standing relationship with Sean. Also, Hiro Yoshimura is elderly Japanese porn star who comes to McNamara/Troy requesting surgery to remove a surgical scar before his big debut in an American porn movie.

A middle-aged woman requests liposuction in order to compete with younger women for her dream job of selling clothes.

Comedian Joan Rivers comes in requesting all of her previous plastic surgeries to be undone.

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.

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

While Sean operates on a model who was raped and scarred by a serial killer, an unsatisfied patient sets out to destroy his reputation.

Christian discovers that his former rival has been working as a cheap plastic surgeon and performing dangerous operations on desperate patients.

Sean and Christian must fix the nose of an abused housewife, whose husband is in prison for killing their child.

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

Sean and Julia are shocked when Annie enters early puberty. Mrs. Grubman returns, requesting a knee lift.