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.

The teenage daughter of Escobar Gallardo seeks out Sean and Christian for answers about her late father, stirring tremendous guilt within Sean. A seemingly common cosmetic procedure for a struggling actress leads to chaos.

Secrets are revealed and past pains are uncovered as Sean and Christian begin psychotherapy together. Liz and Matt divulge their own confidences when they each join a therapy session.

Concerned that cosmetic surgery is no longer in vogue, Sean and Christian make a unique attempt to market their surgical practice to boost a lagging clientele. Liz goes on a date with a pharmaceutical representative who is separated from her husband. Christian's unconscious existential crises, including his loss of Kimber, come to light.

Julia visits Sean and Christian in Los Angeles to share life-changing news -- and rejects romantic advances from both men. A great love from Matt's past who has caused immeasurable family chaos turns up as Matt prepares to marry Ramona. Liz reveals that she's happily pregnant.

Sean and Christian reflect on their relationship. They also remove a scar from an elderly Japanese man and have a surprise for Liz. Meanwhile, Christian makes a deal with Ava.