Sean McNamara and Christian Troy are best friends and own a plastic surgery practice together. Their friendship and business is put to the test when Christian, unbeknownest to Sean, accepts drug money to perform surgery on a Columbian drug lord.
At home, Sean's relationship with his wife, Julia, begins to strain.
At Sean's insistence, Christian agrees to hire a staff psychologist. However, the male candidate they choose is no more ethical than Christian. As Sean and Julia continue having trouble in their marriage, Sean becomes attracted to psychologist Dr Grace Santiago.
Christian becomes furious when Sean agrees with Grace, now the practice's in-house psychologist, about a woman's desire for extensive surgery in order to look beautiful for her high school reunion. Julia is ordered to attend anger management classes when she is reported to animal services for flushing Annie's pet gerbil down the toilet.
Christian tries to persuade Sean to go into business with a successful pornography production company whose performers need cosmetic surgery. However, the new arrangement causes problems when the practice's more upscale clients feel uneasy. Sean examines a young transsexual, Sofia Lopez, who wants to correct a botched sex-change procedure.
Sean and Christian interview a potential patient, a Caucasian man who wants his eyes to look Asian. Meanwhile, Julia must choose between medical school and motherhood again when she discovers that she’s pregnant.
When Christian's prized possessions are vandalized, he contacts the women he has wronged in the past to find the culprit. In the process, he reconsiders his behavior towards women in general. Meanwhile, Sean is invigorated after an encounter with a patient, Megan O'Hara, a chiropractor going through a divorce.
Julia clashes with Sean regarding how to parent Matt, but Matt appreciates his father's support. Meanwhile, Christian attempts to maintain an honest relationship with his girlfriend and Sean visits Megan O'Hara for more than just a chiropractic session.
While driving his friend Henry home, Matt hits pedestrian Cara Fitzgerald. Guilt-stricken, Matt visits the comatose girl in hospital and meets her mother, a strict Christian Scientist who refuses to allow doctors to do any re-constructive surgery on Cara's terribly injured face.
Christian accompanies his girlfriend Kimber to a spa where they encounter rival plastic surgeon Merrill Bobolit. Nurse Liz becomes closely involved with male-to-female sex-change patient Sofia Lopez, while Sean and Megan finally consummate their relationship in a hotel.
An error during surgery causes Christian to lose his confidence before a medical board test, and Sean is devastated by Megan's illness. When she asks him to help her commit suicide so she can die with dignity, he agrees.
After operating on Montana Caine, Sean and Grace are astounded to discover that she has a multiple personality disorder. Meanwhile, two gay men beg Christian to help get medical cover for their adopted son since they can't legally receive benefits.
Christian and Sean operate on a South American woman and discover that she’s being used to carry liquid heroin into the US in her breast implants. Ruthless Colombian drug lord Escobar Gallardo blackmails them into removing the implants and handing them over.
In the season finale, Escobar Gallardo's demands that Sean and Christian perform free breast implant removal operations on the women he uses to smuggle heroin nearly force the practice into financial ruin. When they refuse, Escobar resorts to violence. Meanwhile, Sean's troubles at home worsen and he and Julia move closer to divorce.
Sean turns 40 and begins to rethink everything in his life. Christian wants to stop his feelings of aging and decides that taking care of Wilbur will make him a better person, and the father that he never had. Julia is shocked to get a visit from her mother, an overbearing woman who demands Sean give her a face lift.
Christian breaks his nose during a regular round of bedroom acrobatics. This forces him to examine his own vanity. Sean's hand palsy gets worse and he has to talk to Christian while finding a solution to save his surgical career. Matt must make a decision about Cara's hit and run in order to save his friend, Henry.
A Somalian woman turns to McNamara/Troy to help reverse her country's custom of female genital mutilation. Not only do the doctors have to reconstruct her body, but her self-image. Since Julia is struggling with inner demons, Sean introduces her to a life-coach who he thinks will be able to help her.
Annie is approaching puberty, and Julia and Sean must deal with this accordingly. Gina tells Christian that he can no longer be involved in Wilbur's life. Christian goes to see an ex to build a case against Gina, for sole custody of Wilbur.
Sean gets in a car accident while using his cell phone. Because of the accident, Sean develops a fear of driving and other dangerous things. This causes a dent in his career. He meets with a man about getting a job at a crash test facility. Christian is reminded that his son is no longer in his life.
Bobbi Broderick is convinced that Sean lied to her about her lip. She goes a personal smear campaign aimed at McNamara/Troy. Ava offers Matt sex in exchange for him bringing his grades up. A woman who has had her lips burnt off goes to Christian and Sean for help. Ava learns who Matt's real father is.
A local model is disfigured by an attacker, known as the Carver. Sean does pro-bono work to repair her injuries. This puts McNamara/Troy into the media spotlight. Matt begins to get uncomfortable with Ava's increasing relationship demands. She opens Matt up to a secret that threatens to destroy his existence.
Christian and Sean assist a woman experiencing a religious phenomenon, when she shows up with stigmata wounds. Christian tries to help Matt with his new love. Julia reveals her secret to Sean who takes it out on her and Christian.
Sean wants to dissolve the practice but the two doctors must first go to New York for a high profile procedure: the separation of conjoined twins. While their Christian and Sean learn what professional separation will do to their lives.
While his marriage dissolves, Sean find solace in the company of Kimber. She needs his help with her new business opportunity. A male journalist wants to get breast implants so he can better understand his wife's battle with breast cancer, and get material for his new book.
Christian falls for his blind patient. She cannot see his handsome exterior but only into his soul for which she generally appreciates him. Sean continues to show off his new life style while rejecting Julia's attempts to reconcile. This causes Julia to make a huge decision to promote a changer in her life.
Julia suffers an accident that leaves her in bad physical and mental shape. She turns to Sean to heal her. Under anesthesia, Julia imagines what her life would be like if she had married Christian instead of Sean.
Sean and Christian discover that Merill Bobbolit is doing illegal back room cosmetic surgeries. Christian is determined to help him recover. Ava bribes Christian into performing surgery on an aging high school principal.
Sean and Christian repair the face of a woman who has been abused by her husband. They discover that they have only enabled the woman's abuser. Sean and Julia confront Ava about her relationship with her son, Adrian. They are trying to get Matt back.
Sean has been doing pro-bono work on the victims of the Carver, a serial rapist who preys on the beautiful people and carves their faces as a message to society. Christian gets horrifying news that will affect his personal and professional lives.
Joan Rivers goes to consult with Christian and Sean, but her requests manage to astonish them. Sean, Christian and Julia learn the shocking truth about Ava - something that could destroy her life and completely devastate Matt. Sean must make a decision on how to deal with the Carver.
In the aftermath of Christian's attack by "The Carver," Sean must forge a new partnership to keep the practice going. The police request Sean's medical expertise for an obese woman named Momma Boone who has not left her home for over three years. Julia realizes it is time to make a decision about the future of her marriage.
Christian and Liz perform cosmetic surgery on an extraordinary ape to help her chances of reproducing. After learning that Ava is a trans gender woman, Matt questions his own sexuality and heads down a dark path. Tensions escalate at McNamara/Troy as Sean and Quentin, against Christian's wishes, remove the tattoos of a gang member who wants to go straight..
Sean, Julia and Christian struggle to find a common solution as Matt spirals out of control. Christian performs surgery at his former fraternity house to help cover up a hazing ritual gone awry. When Christian's open relationship with Kit--the sexy detective investigating the Carver's activities--and Kimber loses its appeal, Christian asks Quentin to help ease Kit out of the threesome.
Christian has doubts about the latest Carver victim's story. The wife of an Alzheimer's patient requests extensive cosmetic surgery in order to find a way back into her husband's memories. Sean finds himself under investigation by Child Protective Services after Matt files a restraining order against him.
Christian becomes the prime suspect in the Carver case after police find a damning piece of evidence at the scene of the latest Carver attack. An HIV-positive man who suffers from facial wasting comes to McNamara/Troy to have his appearance restored to one of good health.
McNamara/Troy is in dire financial straits after Christian's arrest. Gina returns and forms an unexpected business alliance with Julia. Sean and Christian reluctantly become involved in the gruesome case of a man who reassembled a female corpse from the appendages of other dead bodies.
A patient's extreme surgical request leaves Christian struggling between what the medical establishment says is right and what the patient says will make him feel whole. After leaving McNamara/Troy, Sean takes his surgery skills to the Witness Protection Program, where he transforms the appearance of a woman, Nicole Morretti, and her son, Austin. After a De La Mer Spa client reveals her startling beauty secret to Julia, Gina and Liz, they manufacture a new signature product--and hope the main ingredient remains a secret.
Sean questions his growing romantic feelings for Nikki when he learns the dark truth about her past. The request for plastic surgery from a patient with Down Syndrome moves Christian to make contact with his birth mother, Gail Pollack. Quentin woos Julia, who welcomes the attention.
Christian and Quentin's mutual dislike deepens when they disagree over the ethics of a groundbreaking surgery that would enhance their medical reputations. Having fallen for Nikki, Sean can't face letting her disappear into the Witness Protection Program without him. Christian gives Kimber a pre-nuptial ultimatum: give up her career in adult films or give up the wedding.
Christian and Kimber put the final touches on their wedding plans, but an unsigned prenuptial agreement casts a shadow of doubt across the occasion. Christian and Sean are stunned when Matt's new girlfriend compares plastic surgery to the work of Nazis.
Furious that Quentin is dating Julia, Sean resolves to do whatever it takes to force Quentin out of the practice. Christian claims to be fine after Kimber's sudden exit, but his relationship with a patient indicates otherwise. Sean worries Matt may be linked to a series of hate crimes against former plastic surgery patients.
Julia fights with her visiting mother and urges her to take an earlier flight back home to New York. The plane crashes on takeoff. As a guilt-ridden Julia awaits word of her mother in a makeshift hospital, she pitches in to comfort another woman's dying mother. Sean and Christian also try to save victims, but Quentin isn't there. At the spa earlier, he said something to Julia that really gets under her skin.
A shopping-mall Mrs. Santa Claus comes to McNamara/Troy for liposuction before the holidays, but a discovery during surgery jeopardizes her marriage to Mr. Claus. Julia must make a decision that could profoundly affect the rest of her life and the lives of her family. Ariel asks Matt to help her take drastic measures to alter her appearance.
The Carver's back in the picture in the third-season finale, and Christian tells Kit that Quentin should be her suspect. But first, Sean and Christian receive a bloody package. Its contents: Kimber's breast implants. Meanwhile, Julia learns something about her pregnancy; and Sean, Christian, Matt and the transsexual Matt had beaten up are involved in separate games of torture.
The Carver attacks sorority-house residents, Kit begins to close in on the elusive assailant, and the identity of the Carver is at last revealed. Elsewhere, Julia learns something about her condition; Sean, Christian, Matt and Cherry Peck are involved in separate games of torture.
While celebrating their five-thousandth surgery, Christian and Sean meet Jill and Riley White, mother and daughter – whom Christian takes home to help with his celebration. Christian is very attracted by Riley; but ever since his break-up with Kimber, he hasn't been able to have a stable relationship, and refuses to kiss either of the girls. He starts to consult with a shrink about the direction that his life has taken and the shrink brings up some very interesting questions about his relationship with Sean.
Christian meets with Burt Landau, a patient approximately 70-years-old and his wife Michelle who is barely half his age, whom he’s been married to for just over a year. Michelle explains that Burt has prostate cancer, and after the removal of his testicles he complains that his replacement ones are not “big enough,” and asks for a pair the size of kiwis. Burt Landau explains he is managing a big firm called "Landau Industries" based on profits (benefits), and his wife offers to purchase McNamara/Troy and keep Christian and Sean on as employees.
While consulting with her doctor, Julia learns that her baby actually does have a birth deformity and doesn’t know how to tell Sean. When she finally musters up the courage he is enraged that she didn’t tell him about the possibility when it was still early “to do something about it.”
Sean meets with a 50-year-old phone-sex operator, who after 20 years of being an alcoholic and a pack-a-day smoker wants her husky/damaged voice repaired.
Matt still recuperating after the events of the last three months has turned into a semi-hermit living in his family’s garage and rarely ever coming out and Kimber is MIA.
A rich gay man wants to have his younger boyfriend's face remolded in his image, but Christian thinks it's a bad idea. Christian also performs a breast reduction on a lap dancer for free, but new boss Michelle thinks that's a bad idea. She also doesn't approve of Sean's pro-bono work for a disfigured young man. Meanwhile, Matt runs into Kimber, who introduces him to Scientology.
Sean and Julia interview a possible nanny. They both like her a lot. Sean got a hybrid car. Christian goes to the gym and is envious of another plastic surgeon there who's in much better shape than he is. Christian encounters a changed Matt in the gym.
Shari Noble comes in with one of her nipples bitten off, apparently by her dog. She wants it reconstructed before her husband returns from Iraq. Christian goes to a lesbian bar with Liz, where he tries to attract the attention of a woman but she's attracted to Liz instead. Sean and Christian meet with a kidney specialist for a patient of theirs. Julia talks with a breast-feeding expert.
A lottery winner wants Christian to perform extensive plastic surgery on her---and her husband and daughter. Christian does so, and more. He can certainly use the money because James is blackmailing him over his affair with Michelle. Elsewhere, Christian and Sean try to win Matt's affection with a Porsche, but he's leaning toward Kimber and Scientology; and Sean buys an engagement ring for Julia.
Therapist Faith Wolper asks Christian to remove a tattoo from a sensitive area of her body, and Burt Landau asks him to remove something from a sensitive area of his body. Later, Burt hits a nerve with Christian and Michelle. Meanwhile, Sean and Julia's second honeymoon is jeopardized by nurse Marlowe Sawyer's illness, but Monica Wilder volunteers to fill in. Sean doesn't think it's a good idea.
Liz collapses at work, because her sole kidney is only working at 10% anymore. Christian and Sean are going to take the test if they can donate one of their kidneys. Burt Landau wants a re-constructive surgery for his face after a stroke caused by the side effects from Viagra.
A secret from Sean's childhood compels him to move up Conor's surgery, despite Julia's apprehension and Marlowe's objection. Mrs. Grubman visits Christian to make her final request for cosmetic surgery. Julia and Marlowe use Conor to mask their changing relationship.
Liz has cosmetic surgery at the request of her new girlfriend, Poppy; a desperate James uses Christian to lure Michelle into helping her steal another kidney; and Sean offers a surgical consult to Marlowe, who wants a leg-lengthening procedure in order to impress the woman he loves.
Merrill Bobolit returns, knowing some very interesting information about Sean and Christian. This information leads back to crime lord Escobar Gallarado, who blackmails the surgeons into repairing his burned face. Sean confronts Marlowe, and the truth flows from everyone, including Matt, who's news shocks everyone.
The episode starts out with Conor, now at 20, having a discussion with a psycologist. Conor is finally at long last, having his re-constructive surgery on his right hand, in just two days. But before the surgery takes place, Conor wishes to tie up some loose ends of his past, which is why he is seeing a psychologist.
Conor decides to organize a family dinner so that everyone may meet the surgeon that will be performing his surgery, even though, he explains, the family is not close. Conor states that Julia and Sean have separated, Matt is almost never around, and Annie feels as if she was neglected as a child, and resents Julia.
Nevertheless, the family meets at a diner. Sean almost decides to leave once he sees that Julia is at the dinner, but is soon convinced by Christian (who is also attending the dinner, and who appears to still be the playboy he was 20 years ago), and Conor to stay. Soon after, Matt arrives. Conor reveals that Matt, now a surgeon like his fathers, will be the one performing the surgery.
Sean is disappointed that he was not asked to perform the surgery, but tries to hide his emotions.
Meanwhile, back in 2006, Sean and Julia's marriage is falling apart once again.
Christian proposes to Michelle even though he doubts his ability to maintain a long-term relationship; a lonely Sean takes a morbid case for reasons that have as much to do with himself as with the patient; and James wants to use the McNamara/Troy OR for her own operations.
Sean drinks heavily as he spends a gloomy Christmas without his family; Christian receives an unexpected gift when a 3-year-old Wilbur comes back into his life; and James forces Michelle to help as she takes drastic measures to fill her holiday kidney quota.
Sean comes to a decision regarding his future, but first he performs a face-lift on a ventriloquist who tells him he needs the surgery to "compete" with his puppet. Meanwhile, Gina returns with a request regarding Wilbur that Christian is not inclined to grant; James ends her association with Escobar; Matt attempts to rekindle the spark with Kimber; and Liz breaks up with Poppy.
Sean weighs a major decision concerning the practice, and Michelle's dark past comes to light, threatening her relationship with Christian. Meanwhile, Escobar seeks cosmetic surgery for his wife, who was attacked by an enemy of his.
Christian and Sean try to rebuild their practice at a new location. Meanwhile, a Hollywood publicist offers to help rebuild their image.
Sean and Christian begin to realize the price they are willing to pay for fame. Meanwhile, Julia visits Sean, Christian and Liz in Lost Angeles.
Sean and Julia examine their family dynamic and Sean continues to resist Eden's forward advances. Meanwhile, Kate reveals her compulsion and Matt arrives in Los Angeles.
The unlucky Dawn Budge returns to get more services from Sean and Christian. Meanwhile, Annie and Eden continue to bond which worries Sean.
Sean is inspired by a patient to further his relationship with Kate. Eden goes to extremes to surgery performed on a friend by Christian. Kimber seeks help from a former business associate after she and Matt fall on hard times.
Christian, horning in on Sean's newfound fame, convinces him to film a reality based show concerning their plastic surgery careers.
Sean uses his relationship with Eden to recapture his youth. Also, a violent and traumatic event makes Julia question her relationship with Olivia and Matt is devastated by Kimber's decision.
A secret about Julia that Christian has keeping to himself is discovered by Sean. Matt forms a bond with his rehabilitation counselor at the hospital. Meanwhile, Eden's peace agreement with Julia seems suspicious, while Kimber and Ram reveal their plans for the future.
"Hearts 'n' Scalpels" producer Dawn Budge, refuses to allow the show to join a gay-pride parade. Meanwhile, Christian starts with his old habits again, and Sean hires Gina as a receptionist, to get back at Christian because of Julia. Also, Matt's disfigured rehab counselor, Rachael Ben Natan, sees Sean when ever experiencing a face pain, but the case is more intense than it seems.
An older woman wants the effects of her younger husband's electrolysis procedure undone by Sean and Christian. Meanwhile, a talent agent is hired by Sean; Christian wants to know why Gina is moving to Los Angeles; and Julia's illness is still a mystery.
Christian attempts to move on in the wake of Gina's death. Also, when another agency becomes interested in Sean's career, Colleen feels her business is being threatened.
Sean helps out Eden when she joins Kimber and Ram in business. Christian is hired by a group of socialites to perform their cosmetic surgery wants, and Sean sees a different side of Colleen.
Sean is shown the ugly side of Hollywood from a TV critic, while Matt and one of Christine's patients experience a close bond. Also, Julia finally gets an explanation of why she's been ailing.
Julia discovers the cause of her poor health as tragedy strikes the McNamara/Troy family. Meanwhile, revealing news from Christians past is uncovered by a visitor, and Sean finds that fame comes with a price.
After surviving the attack by Colleen, Sean's physical and emotional well-being are still feeling the effects. Meanwhile, Christian receives some disturbing news after lending Liz some moral support with her breast cancer scare.
Liz is drawn closer to Christian due to his illness, and Sean reconnects with his family.
Sean tries to come to grips on her feelings for Julia, as he prepares to operate on Olivia. Liz and Christian analyze their relationship after having an intimate encounter. Christian meets someone who is familiar with his emotions as he attends a breast-cancer support group.
Matt notices that Sean and Raj are starting to bond like father and son, as he questions his own decision to become a doctor. Suddenly, Raj's father shows up and stuns him with a request. Meanwhile, Christian and Liz want to work on making their relationship work out, and Sean tries to make an 18-year old look older with surgery. The young man has just married his former teacher, who served prison time because of their relationship.
Aidan Stone, a down-on-his- luck writer who has written a biopic about Sean, wants to use it to relaunch his career. Christian is asked by Kimber to give a Botox injection to her daughter so she has a better chance at becoming a baby model. Sean and Christian have been asked by a yoga instructor to perform a procedure in which neither have ever done before.
A horribly disfigured man is worked on by Christian and Sean. Meanwhile, Sean hopes to strike up a relationship with the new anesthesiologist Teddy Rowe, and Christian goes for a check up with his oncologist.
While preparing for a big event, Lizzie has a clash with her mother, and Christian searches for a new surgeon for the practice. He chooses Dr. Logan Taper, who loves his new office. Meanwhile, a dying man insists his wife comes back and receives more plastic surgery from Sean, so she can attract the right kind of suitor after he's gone.
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.
Sean and Christian are in a struggle keeping McNamara/Troy thriving. Matt and Kimber find their career paths to have mixed results. Sean remains distant from Teddy.
Sean tries curing his insomnia using unusual methods. Meanwhile, Liz confronts Christian, and hands some unsolicited advice to Kimber.
Sean doesn't consult family or friends before making an impulsive life change. A morose Annie makes a stop in New York with a disturbing medical condition. Mike is offered advice from Christian on how to satisfy Kimber and a new patient recognizes Teddy from her past.
Christian's patient is dealing with anger management issues. Sean and Christian discover how Matt earns an income. Teddy arranges a camping trip with Sean, Annie and Conor.
Matt's recent crime spree begins to catch up with him as Julia returns from New York to help him recover from his surgery. Meanwhile, Sean receives devistating news about his marriage, and a patient suffers from separation anxiety.
Erica gets married and threatens to try to win custody of Annie and Connor. This leads Sean and Julia to put forward a happy front in order to stop her custody efforts. Meanwhile, Christian bonds with a patient, and Mike tells Kimber about his plans.
Matt and Alexis both go to Christian asking for unusual procedures to be done. Erica learns the truth about her new husband, as Julia plots revenge on her mother.
Christian's debt begins to grow, leading him to deception in order to try to get out of it. Meanwhile, an unexpected visitor brings out Christian's insecurities, but elates Sean; and Christian bonds witha patient about to be adopted.
Sean faces a moral dilemma when McNamara/Troy is asked to perform a surgery on a prison inmate. Meanwhile, Kimber debates how far to go to keep Christian.
Sean and Christian are given an award from their alma mater, leading Sean to reminise about his years in college. Meanwhile, a self-mutilating patient comes to McNamara/Troy for reconstructive surgery.
Christian refuses to perform surgery on a patient who wants drastic work done. Meanwhile, a patient awakes from a long coma and asks Sean to perform surgery to regain his lost years.
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.x
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.