When Sean and Christian win an award from their alma mater, Sean recalls their college years; a new patient who self-mutilates comes to McNamara/Troy for reconstructive surgery.

Christian refuses to perform surgery on a model who wants to drastically alter her beauty. Awakening after a decades-long coma, a new patient seeks surgery from Sean in order to regain his lost youth. Kimber redecorates Sean's new apartment.

The Christian and Kimber marriage is lacking where it matters most for the two...in the bedroom. In an attempt to steam things up Christian begins a dangerous new sexual act with Kimber. When all fails Christian is forced to make a decision about his marriage. Sean's ever increasing disgust of Christian begins pushing him to leave the practice and pursue a long dreamed job far away from the practice. Kimber's ultimate failure to achieve happiness leads to a possible series changing event for Nip/Tuck.

Kimber's mother pays a visit under sad circumstances. In typical Christian fashion he takes advantage of her visit. Sean's dedication to leaving the practice for Doctors Without Borders hits a wall. Shelia Carlton, the patient of the week, comes in for surgery after being savagely attacked and half her face ripped off by a chimp.

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.

Sean and Christian reveal secrets and lay bare past pains as they begin psychotherapy together. Liz and Matt take part as well, and divulge secrets of their own. Guest starring Melonie Diaz.

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.