Ms. Caine wants an operation to get rid of her "cankles". Sean and Julia are still on the outs. Christian learns he's going to be a father. Julia steals Christian's brush to determine if he's the father of Matt. Sean and Grace learn that Ms. Caine has multiple personalities. Cara recovers and gets close with Matt and Henry. Henry develops feelings for her. Cara asks Matt to the prom. Henry tells Matt that he is going to confess to Cara what happened.

Sean hires Quentin Costa for six months during Christian's convalescence. The two remove tattoos from a former MS-13 gang banger using cutting edge laser technology. Matt finds Adrian dead in Ava's house when searching for a plane ticket to Paris. The police thinks it's suicide. Julia calls Erica to help Matt deal with questions regarding his sexuality. Christian and Liz operate to repair a scar on the face of a female gorilla, Kiki.

Seeking fulfillment in his life, Sean becomes a surgeon for the Witness Protection Programme. A man suffering from Body Integrity Identity Disorder (BIID) threatens Christian's life in order to force him to amputate his perfectly healthy leg. Julia, Gina, and Liz develop a new skincare product that uses semen as the main ingredient. They keep the main ingredient a secret though. Joan Rivers is the first to test the product and loves it so much she decides to endorse it.

A plane crashes just after take off in Miami. Julia's mother might be one of the passengers. Christian, Sean, Julia and Liz are all trying to save the lives of the people that survived the plane crash.

Sean and Julia learn more about their new family dynamic as Sean resists Eden's advances. Kate reveals a secret compulsion. Matt comes to Los Angeles with some troubling news for his fathers.

Sean discovers the secret between Christian and Julia. A hospitalized Matt bonds with his rehabilitation counselor. Eden suspiciously makes peace with Julia. Kimber and Ram reveal their future plans.

After being rejected by Kimber on account of his post-surgery scars and with his chemotherapy making him sick, Christian seeks support from Liz, which leads to a surprising sexual encounter between them. Sean discovers his new lover (Jaime Ray Newman) has a disturbing fetish, and further alienates Julia and Matt when they learn that he has been faking his need for a wheelchair. Raj has a life-altering sexual encounter with the wife (Beth Gargan) of McNamara/Troy's latest patient.

As Christian and Liz make their wedding plans, he also looks for a new cancer treatment. Meanwhile, Ram Peters drops Kimber for a newer model, while Teddy informs Sean that someone close to her is gone, and Sean and Christian repair a couples neck wounds which look strikingly similar at McNamara/Troy.