Nip/Tuck

While the money and women continue satisfying Christian's needs, years of selling a phony image have taken their toll on Sean and distanced him from his wife, Julia (series star JOELY RICHARDSON), and children, Matt (series star JOHN HENSLEY) and Annie (recurring guest star KELSEY LYNN BATELAAN). Exasperated with Christian's questionable professional behavior, Sean strongly considers dissolving the partnership, but Christian forces him to remain. Sean demands that they begin performing pro bono surgical work. The tense situation quickly becomes deadly when a Colombian drug lord arrives in search of a former employee who has had extensive facial reconstruction.

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, teenager Matt asks Christian for help getting a circumcision to please Matt's girlfriend. Sean and Christian meet gorgeous identical twins who want to change their features in order to establish unique identities. Meanwhile, Sean becomes attracted to the twins' psychologist, Dr. Grace Santiago (new series star VALERIE CRUZ). Christian offers to watch over Julia while she and Sean are separated--but, unbeknownst to Sean, Christian has his own agenda with Julia.

Christian becomes furious when Sean agrees with Grace, who is now the practice's in-house psychologist, regarding a woman's desire for extensive surgery in order to look beautiful for her high school reunion. However, Christian later realizes that Grace may have been right about the patient's mental stability. Meanwhile, after finding Matt dazed and bleeding from attempting a self-circumcision, Sean agrees to perform the procedure properly and prevent permanent damage. But Sean is unable to operate on his son, so Christian does the surgery in exchange for Sean taking Christian's most demanding patient. Sean's nervousness results in an oversight that forces Christian to make an unsavory deal to save the practice. And 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 very successful pornography production company whose performers need cosmetic surgery. However, the new arrangement causes problems when the practice's more upscale clients become uncomfortable with the office atmosphere. Christian brings Matt to a consultation at a porn production, but Matt's subsequent encounter with a young starlet strains Christian's friendship with Julia. Meanwhile, Sean examines a young transsexual, Sofia Lopez, who wants to correct a botched sex-change procedure. Sean's revulsion turns to compassion after listening to the patient's life story. He is horrified to learn that the incompetent doctor who performed the procedure was his medical school mentor. Also, Julia takes classes to pursue her dream of graduating from medical school, but she feels insecure and worthless when she meets her instructor, a longtime college friend who has balanced career and family successfully.

Sean and Christian interview a potential patient, a Caucasian man who wants his eyes to look Asian so he can be accepted by his fiancée's family. Meanwhile, Sean suspects domestic abuse when he notices old scar tissue on a patient while performing a nose job. And Julia must choose between medical school and motherhood again when she discovers that she is pregnant.

When Christian's prized possessions are vandalized, he tries to contact the women he has wronged in the past to find the culprit. In the process, he continues to ponder his behavior towards women in general. Meanwhile, Sean is invigorated after an encounter with a patient, Megan O'Hara (recurring guest star JULIE WARNER), a chiropractor going through a divorce. And Matt's ex-girlfriend, Vanessa Bartholomew (recurring guest star KATE MARA), asks for his help to revitalize her relationship with her new girlfriend, Ridley Lange (recurring guest star SOPHIA BUSH - "One Tree Hill").

When Julia surprises Matt having sex with both Vanessa Bartholomew (recurring guest star KATE MARA) and Ridley Lange (recurring guest star SOPHIA BUSH), she humiliates him by demanding an intervention with Ridley's nonplussed mother and Vanessa's outraged parents, who didn't even know that Vanessa is a lesbian. Julia also clashes with Sean regarding how to parent Matt, but Matt appreciates his father's support. Following Sean's advice, Matt forms a stronger friendship with Vanessa, even though she cannot love him. Meanwhile, Julia flirts with her classmate, Jude Sawyer (recurring guest star PHILLIP RHYS), but balks when he invites her to a swingers' party. As Christian attempts to maintain an honest relationship with his accommodating girlfriend, he must confront his feelings for Julia after he mistakenly thinks he sees her at the swingers' party with Jude. Although clueless Sean had hired Jude as an intern as a favor to Julia, Christian terminates Jude.

While driving his friend Henry (recurring guest star ANDREW LEEDS) home, Matt looks away from the road and strikes a shy girl, Cara Fitzgerald, throwing her out of sight into a ditch. Disoriented and worried because there is marijuana in the car, the boys don't realize that they've hit a pedestrian and leave the deserted area. But later, Matt learns that Cara is hospitalized in a coma. Guilt-stricken, he visits her and meets her mother, a strict Christian Scientist who refuses to allow doctors to do any reconstructive surgery on Cara's face, which is destroyed. Without admitting to anyone that he is responsible, Matt persuades Sean to convince Cara's mother to allow him to fix Cara's features--and prevent blindness--for no charge, in order to save her from a lifetime of social rejection. Henry, an Orthodox Jew, tearfully almost confesses to Julia, but Matt stops him.

Christian accompanies his sexy girlfriend, Kimber Henry (recurring guest star KELLY CARLSON), to a spa where they encounter rival plastic surgeon Merrill Bobolit (recurring guest star JOEY SLOTNICK). Eager to break up with the clingy Kimber, Christian agrees to a hideous deal, "trading" her for Bobolit's Lamborghini sports car. The men concoct a manipulative scheme to bring Kimber and Bobolit together, but she later finds out the truth and gets revenge on Christian during rough sex play. Meanwhile, as the doctors' nurse, Liz Winters (recurring guest star ROMA MAFFIA), consults with male-to-female sex-change patient Sofia Lopez (recurring guest star JONATHAN DEL ARCO), they become attracted. Upon learning that Liz recently broke up with her girlfriend, Sofia offers to give Liz a makeover, during which they kiss. Confused, Sofia cancels the surgery, but Liz eventually persuades her to undergo it.

An error during surgery causes Christian to lose his confidence immediately before he and Sean must take a surgical test for recertification by the medical board. Christian's situation worsens when he finds out that he has received a difficult assignment for the examination: to perform cosmetic surgery on the cadaver head of a midget. He persuades a morgue worker to let him practice on a small corpse. Meanwhile, exhausted and stressed by the imminent death of his cancer-stricken lover, Megan O'Hara (recurring guest star JULIE WARNER), Sean operates on a dead woman's head for the test and hallucinates that it is speaking to him. The head voices the thoughts of Sean's conscience, eventually infuriating him so much that he runs out of the examination room.

After operating on a woman, Montana Caine (CHERYL WHITE), for varicose veins, Sean and Grace are astounded to discover that Montana has multiple personality disorder. Montana's alter ego Sassy is an impetuous child who now wants her breasts reduced. Although Montana's therapist warns that if Sassy, a sort of gatekeeper personality, is not appeased, other personalities may be unleashed, Sean refuses to perform the breast reduction. However, after Montana transforms into Justice, a frighteningly tough male who demands the surgery, Sean complies before any other personalities show up. Meanwhile, two gay men beg Christian to petition a social worker to allow medical coverage for their adopted son with a cleft palate, since they cannot receive benefits like legally married parents would. Upset at being forced out of Julia and Sean's family because of their marital difficulties, Christian pities this modern family unit and does the surgery for free and at his own risk.

Christian and Sean operate on a South American woman with grotesquely huge breasts and discover that she is being used to carry liquid heroin into the U.S. in her implants. Ruthless Colombian drug lord Escobar Gallardo (recurring guest star ROBERT LaSARDO), whom the doctors previously encountered when they created a new face for one of his former henchmen, blackmails them into removing the implants and handing them over. Escobar knows about the dead body that Christian and Sean deposited in the Everglades--and he knows where Sean's family lives. The frightened surgeons must agree to continue performing the operations on poor, misguided young women who want to immigrate to America but end up putting their lives in danger.

Meanwhile, Julia's judgmental classmates at a fitness center object to Sean's transsexual patient, Sofia Lopez (recurring guest star JONATHAN DEL ARCO), joining. Julia refuses to sign a petition and, after having a poignant talk in which Sofia persuades her to try staying with Sean despite his affair, staunchly defends Sofia. The wealthy housewives quit the class, forcing it to be canceled, but Julia gains a surprising new friend and confidant in Sofia.

And Christian struggles with unfamiliar paternal instincts when his well-meaning and lonely ex-girlfriend, Gina Russo (recurring guest star JESSALYN GILSIG), who is 6-months pregnant with his baby, continues her reckless lifestyle. Christian sympathetically asks her to move in with him so he can take care of her and his child.

In the season finale, drug lord Escobar Gallardo's (recurring guest star ROBERT LaSARDO) demands that Sean and Christian perform free breast implant removal operations on women Escobar uses to smuggle liquid heroin into the United States nearly force McNamara/Troy into financial ruin. But the loss of potential patients to the surgeons' rival, Merrill Bobolit (recurring guest star JOEY SLOTNICK), is especially stinging to Christian. When he confronts Bobolit about falsely advertising Kimber's (recurring guest star KELLY CARLSON) surgery as Bobolit's work, Christian learns that his former girlfriend is now engaged to the prosperous Bobolit, and the couple is determined to ruin McNamara/Troy. Meanwhile, Sean's troubles at home worsen, and he and Julia move closer to divorce. Christian goes to Julia, explains the situation that he and Sean are in and confesses blame, begging Julia to stand by Sean. As their financial woes deepen, the surgeons consider an unusual patient--a dog.

As Sean reluctantly celebrates his 40th birthday, Christian urges him to take advantage of some of the youth-preserving treatments available at the clinic. But Sean vows to grow old naturally. Much more upsetting, however, are the occasional muscle spasms that Sean experiences during delicate surgery, prompting him to visit a neurologist. Meanwhile, after uncharacteristically failing to pick up a sexy young date at the bar, Christian realizes to his discomfort that there is not much he can do to forestall the aging process. Although he is not the father, Christian agrees to help raise the baby of his former sexual partner, Gina Russo (recurring guest star JESSALYN GILSIG), causing him to reevaluate his priorities. And both men must cope with the ramifications of a surprise visit from Julia's narcissistic mother, Erica Noughton who demands plastic surgery for a younger appearance.

Sean suffers uncontrollable spasms in his hands. After he nicks a patient's major neck artery during a routine cyst lancing, Sean stops performing surgeries. He becomes even more depressed and anxious when Christian, whose nose has been broken by a woman during sex, asks another plastic surgeon to reset it. Christian is deeply insulted when the attractive female surgeon not only rebuffs his sexual advances but also advises him to get some cosmetic work done on the rest of his aging body. Sean's temper finally gets the better of him when someone blocks his car into a parking space. But Julia, with the advice of her abrasive therapist mother, Erica Noughton, helps Sean realize that she will love him even if he cannot be a surgeon anymore. And after botching an attempt to operate on himself in a mirror, Christian bolsters Sean's confidence by confessing that he only trusts Sean to do the job correctly.

Christian and Sean agree to rehabilitate a stalwart, optimistic Somali woman, Manya Mabika, who was genitally mutilated as a girl in her home country. After they surgically rebuild her clitoris, Manya asks the perfectly willing Christian to help her have an orgasm, but even he cannot succeed, causing the doctors to worry that the operation was a failure. However, with some kind words and encouragement from Liz, Manya discovers for herself that she can experience sexual pleasure. Sean and Christian also perform a body hair graft onto a white man who is outraged to learn that the hair came from a black person. Meanwhile, Julia admits to Sean that he no longer pleases her in bed. After meeting with a "life coach," Ava Moore, Julia realizes that her visiting mother, domineering Erica Noughton, is making her very tense.

Sean and Julia are shocked to discover that 8-year-old Annie is entering puberty already. While struggling with their own issues regarding aging, they try to help their daughter understand what's happening to her. Julia serves the family a healthy but bizarre meal that is supposed to improve their mental health, but Matt refuses to eat it and upsets Annie by making cruel comments about her menstruation. Later, Sean and Julia fear that Annie has food poisoning when they must rush her to the emergency room with a dangerously high fever, dehydration and numbness. But the real problem with Annie is much more scary for them to cope with. Also, Julia introduces her new friend, "life coach" Ava Moore, to Matt, hoping that she will help him cope with his tumultuous emotions. Meanwhile, Christian reels from meeting the biological father of Gina's baby, a dignified, married and much older black man, James Sutherland (GEORG STANFORD BROWN), who had a one-night stand with Gina.

While driving home, Sean is broadsided by another car and rushed to the hospital. He was saved from major injury by his vehicle's safety devices, but his view of life has changed. Inspired by a patient, Joel Gideon (DOUG SAVANT), who suffered severe frostbite trying to conquer Mount Everest, Sean plans a shark-diving trip with Matt. Sean intends to prove to Matt--and himself--that he is not a wimp, but when a tragedy occurs on the boat before they can even get into the water, Sean ends up impressing Matt for much more important reasons. Meanwhile, Christian is overwhelmed by the prospect of losing Gina's son to the boy's biological father, James Sutherland (recurring guest star GEORG STANFORD BROWN), who is now demanding custody. Christian teams up with Gina and faces off with James and his inflexible wife through a mediator, with the very real possibility that a negative decision could devastate Christian emotionally. He must also deal with an astounding revelation from Julia.

While Julia enjoys socializing with "life coach" Ava Moore, Matt also makes progress working through his feelings with the alluring Ava--especially when she removes her blouse as part of a trust exercise. But when Matt is later arrested for public lewdness outside Ava's bedroom window, Christian confronts Ava about what she's putting Matt through--and Ava deduces a startling secret about Christian, Julia and Matt. Also, Matt finally confesses his hit-and-run incident to Ava. Meanwhile, an unlikely alliance forms between middle-aged anesthesiologist Liz, a lesbian longing to get pregnant but unable to find a suitable sperm donor, and unfulfilled Christian, who deeply misses being a father. Sean feels guilty after an eager older patient, Bobbi Broderick, who didn't fully comprehend the ramifications of liposuction overreacts to the ugly immediate aftermath.

Disgruntled former McNamara/Troy patient Bobbi Broderick (recurring guest star JILL CLAYBURGH - "An Unmarried Woman," "Starting Over") stalks the doctors, threatens to sue them, drives away customers and tries to persuade an investigative reporter to do an exposé on what she perceives as their malpractice. At the same time, Sean and Christian are moved by the plight of a budding model whose face has been brutally disfigured by a serial rapist. They call her in and repair her face at no charge. Guiltily and reluctantly going along with a plan initiated by Christian, Sean also convinces the victim to allow the surgery to be recorded by the news crew to deflect Bobbi's slanderous efforts. But when Bobbi arrives during the taping of a post-operation interview, the situation comes to a surprising climax.

When a homeless prostitute, Agatha Ripp, arrives at McNamara/Troy, the doctors fear she simply wants pro bono surgery for scars on her wrists. But she tells Christian and Sean that she is being deified by a devout parish of Christians because her injuries resemble the stigmata, the wounds Jesus Christ suffered on the cross. She asks them to reveal to everyone that she caused the injuries herself and is not a spiritual leader. But when a manipulative priest and a sympathetic nun try to take Agatha away--and more wounds appear--Sean and Christian, both nonbelievers, become caught up in a predicament that changes the way they think about faith. Also, while coping with the questions raised by Agatha's situation, Sean experiences a powerful personal crisis as well. Meanwhile, after Liz reveals that she is pregnant from Christian's sperm donation, Christian tries to become more involved in her decisions about the unborn child than she is comfortable with.

Sean's life is in ruins after learning that Christian is Matt's biological father due to a premarital tryst with Julia. He ejects Julia from their house and demands the dissolution of his partnership with Christian. But the two devastated men must first make a business trip to a New York university to separate adult conjoined twins, Rose and Raven Rosenberg in a historic operation. Since the surgery is being performed pro bono, there are no fancy accommodations, and the doctors are forced to share a dormitory room like they did in college, spurring much cathartic reflection on their relationship. After the shocking outcome of the grueling surgery and the other events of the trip, they make a difficult decision on the future of McNamara/Troy. Meanwhile, Matt copes with his pain regarding the family turmoil by continuing to date manipulative Ava (recurring guest star FAMKE JANSSEN), to the concern of Julia, Sean and Christian.

Having tenuously reconciled and agreed to continue their partnership, Sean and Christian consult with an exuberant newspaper journalist, Ike Connors (J.K. SIMMONS - "Oz," "Spider-Man" movies), who wants breast implants for himself. After painfully watching his loving wife, Amy, suffer through breast cancer, a mastectomy and subsequent implant surgery, Ike wants to experience the trauma for himself and live with breasts for a year, during which he will write a book about it, the proceeds of which he will donate to a cancer care center. Both doctors initially refuse the job on ethical grounds, but Liz persuades them that it is better to help someone who seeks enlightenment instead of a simple ego boost, like most of their patients do. After giving Ike some fairly large breasts, the doctors are stunned by Amy's unexpected reaction. When Ike later angrily demands that his implants be removed, the doctors are surprised, but again it is Liz who understands what's really going on.

While the doctors work with an expert ocularist to create and implant artificial eyes for a beautiful blind woman, Natasha Charles (recurring guest star REBECCA GAYHEART), Christian finds himself drawn to Natasha's direct and disarming sensuality. When Natasha makes a date with a man she corresponded with via the Internet, Christian worries that she will fall prey to selfish males like himself--but as his attraction to her grows, Christian discovers that not being able to use his good looks to get what he wants puts him in a vulnerable position. Meanwhile, Sean continues to date model-perfect Kimber Henry (recurring guest star KELLY CARLSON) and harshly spurns any conciliatory gesture made by Julia. With resentful Matt now living with sexy, manipulative Ava (recurring guest star FAMKE JANSSEN), and Annie staying in Sean's house, Julia feels her life spiraling out of control, and a return visit from her emotionally withdrawn mother, Erica, doesn't help.

After taking too many painkillers and drinking alcohol, Julia has fallen through a glass door, severely damaging her face. At first, Sean refuses to operate on her, still bitter that she recently went to a rival plastic surgeon and got breast implants. But knowing that he is the most skilled doctor in town and finally allowing himself a modicum of sympathy for his emotionally disintegrating wife, Sean relents. He and Christian repair Julia's facial injuries and, as she requests, remove the breast implants. While under anesthesia, Julia dreams that irritating but uncompromising life coach Ava (recurring guest star FAMKE JANSSEN) is showing her an alternate universe in which Julia did not leave Christian after their one night of lovemaking during college. Instead of choosing Sean, sacrificing her medical career for children and living with crushing regret, the alternate Julia has married Christian and partnered with him in a very successful surgical practice.

When a poor Latina woman arrives in Sean and Christian's office with horrible blisters on her forehead, the doctors learn that their old associate, Merrill Bobolit (recurring guest star JOEY SLOTNICK), is performing cheap, illegal cosmetic surgery on poverty-stricken people. Feeling guilty because he had reported Bobolit's past indiscretions, which led to Bobolit losing his license, Christian tracks him down and finds the drug-addled surgeon operating out of the back room of a dingy nail salon. As Christian sponsors Bobolit in a 12-step program, the two colleagues bond. But when Christian misses a meeting with Bobolit because of a surgery, the desperate man has a relapse, with terrible consequences for one of Bobolit's misguided patients--and for Christian. Meanwhile, Matt is now attending high school with Adrian, the sociopathic son of Matt's lover, life coach Ava Moore. When Adrian gets into trouble for selling his mother's drugs in school, Matt is implicated as well.

Sean and Christian reluctantly accept the case of Trudy Nye (LISA WALTZ), who wants her nose fixed. Years ago, her abusive husband broke it--on the same day he killed their young son in anger. Now he is getting out of prison early. They believe Trudy's contention that she wants to put her past behind her and forget the pain of her marriage. But when naïve Trudy comes back--accompanied by her husband, who swears he is repentant--and he asks for cosmetic surgery for himself, the doctors must make a hard decision. Meanwhile, Christian's relationship with blind Natasha (recurring guest star REBECCA GAYHEART), is going well, but Christian's self-destructive nature threatens to overwhelm even positive-thinking Natasha. Sean's ongoing affair with Kimber (recurring guest star KELLY CARLSON) deteriorates as she becomes possessive and needy, and it doesn't help Sean to see how happy and healthy Julia seems with her new beau, a New Age tennis teacher named Kevin Hotchkiss.

Sean has been operating pro bono on victims of The Carver, a serial rapist who chooses good-looking people and carves their faces as a message to society about beauty and conformity. After repairing the face of a male model, The Carver's latest victim, Sean attracts the attention of the newswoman who publicized the recent ordeal of Naomi Gaines. But Sean's television exposure has terrible consequences. Meanwhile, already reassessing the choices he's made, Christian receives horrifying news that affects him both personally and professionally. And Ava's son has disappeared with her anti-anxiety medication. Still in love with Ava, Matt is drawn even deeper into her disturbing world. Recurring guest star BRUNO CAMPOS appears as Dr. Quentin Costa.

Celebrity JOAN RIVERS (herself), who is famous for having undergone many cosmetic surgeries, consults with the doctors. However, what Joan requests astonishes even Sean and Christian.

Meanwhile, Sean, Christian and Julia learn the shocking truth about Ava (recurring guest star FAMKE JANSSEN)--and it's enough to destroy her life and devastate Matt forever. And Sean makes an agonizing decision on how to deal with The Carver.

ALEC BALDWIN ("The Cooler") guest stars as Dr. Mercer Moore.

Dr. Sean McNamara (series star DYLAN WALSH) and Dr. Christian Troy (series star JULIAN McMAHON) are plastic surgeons, best friends and business partners who run McNamara/Troy, a prominent South Beach practice. A seemingly conservative family man, Sean has come to realize that his financial success and perfect home can no longer mask the problems of his marriage. On the other hand, single and often promiscuous Christian has few inhibitions and enjoys the benefits of his lucrative career and good looks, even as he yearns to have a family of his own. Sean's marriage to disillusioned Julia (series star JOELY RICHARDSON) is crumbling, and his relationship with his 18-year-old son, Matt (series star JOHN HENSLEY--not appearing in this episode), is troubled and tense. Dr. Liz Cruz (series star ROMA MAFFIA) is the team's opinionated anesthesiologist.

Christian and Liz perform cosmetic surgery on an extraordinary ape to help her chances of reproducing. After learning that Ava (recurring guest star FAMKE JANSSEN) is a transgender 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, Nikki Morretti (recurring guest star ANNE HECHE), and her son, Austin (recurring guest star TANNER RICHIE). 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. JOAN RIVERS guest stars as herself.

Sean questions his growing romantic feelings for Nikki (recurring guest star ANNE HECHE) 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 (recurring guest star KATHY BAKER). Quentin woos Julia, who welcomes the attention.

The working relationship between Christian and Quentin worsens when they have an ethical disagreement over a groundbreaking surgery that would advance their medical reputations. Sean doesn't want Nikki (recurring guest star ANNE HECHE) to disappear into the Witness Protection Program without him. Christian gives Kimber a prenuptial ultimatum: give up her career in adult films or end their engagement.

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, Ariel Alderman (recurring guest star BRITTANY SNOW - "American Dreams," "The Pacifier"), reveals her racist beliefs.

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 fears that Matt may be linked to a series of hate crimes against former plastic surgery patients.

A jet bound from Miami to New York crashes after takeoff--and Julia's mother, Erica (recurring guest star VANESSA REDGRAVE), may be on board. Christian, Sean, Liz and Julia struggle to save the lives of surviving passengers, and Sean must amputate the arms of one of the crash victims.

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 family's lives. Ariel (recurring guest star BRITTANY SNOW) asks Matt to help her take drastic measures to alter her appearance.

Christian learns the truth about Kimber's wedding-day disappearance when he receives a grisly clue from The Carver. Detective Kit McGraw (recurring guest star RHONA MITRA) brings Carver suspect Quentin in for questioning. Cherry (recurring guest star WILLAM BELLI), the transgender woman whom Matt brutally beat, threatens to tell the police about her attacker unless Sean performs pro-bono plastic surgery. Julia's worries about her unexpected pregnancy give her a nightmare.

In the season finale written and directed by series creator Ryan Murphy, The Carver goes on a slashing binge and attacks a sorority house as Kit (recurring guest star RHONA MITRA) grows closer to catching her nemesis. Sean, Christian, Matt and Cherry Peck (recurring guest star WILLAM BELLI) are involved in separate games of torture. Julia makes a discovery about her pregnancy. And the identity of The Carver is finally revealed.

In the fourth season premiere, Sean and Christian celebrate a milestone surgery and receive an interesting proposition from patient Burt Landau (recurring guest star LARRY HAGMAN), a wealthy medical venture capitalist who wants bigger testicular implants, and his much younger wife, Michelle (recurring guest star SANAA LATHAN). Meanwhile, Julie reveals devastating news about her unborn child to Sean, leaving him full of fear and doubt. Phone sex operator Cindy Plumb (KATHLEEN TURNER) requests that the surgeons make her voice more youthful. And tortured Christian redecorates his apartment after a troubling appointment with his psychiatrist, Dr. Faith Wolper (recurring guest star BROOKE SHIELDS).

Sean and Julia make an important decision about their unborn baby. After getting into trouble with their new boss, Sean and Christian discover the drawbacks of no longer owning their practice. Matt's decision to go down a new path in life is met with uncertainty by his family. Meanwhile, an aristocratic gay man, Arthur Stiles (RICHARD CHAMBERLAIN), wants his younger lover to look as distinguished as he does. And James (recurring guest star JACQUELINE BISSET), a woman who has a mysterious past with Michelle (recurring guest star SANAA LATHAN), arrives.

While Sean searches for a night nurse for his newborn baby, Conor, Sean's hidden desires are revealed. He turns to Christian for support, but Christian's vanity causes him to be unavailable at the most crucial time. Sean and Julia eventually hire Marlowe Sawyer (recurring guest star PETER DINKLAGE) to help care for Conor. Meanwhile, Liz witnesses an event that changes her relationship with Michelle (recurring guest star SANAA LATHAN). MARIO LOPEZ guest stars as Dr. Mike Hamoui.

The more Michelle (recurring guest star SANAA LATHAN) resists Christian, the more he wants her--but if Michelle's past is any indication, she has a lot to lose. Meanwhile, Sean's worries about Julia and the baby lead him into a compromising situation. A patient named Shari Noble (MELISSA GILBERT) needs her nipple reattached after an accident. And when Christian accompanies Liz to a lesbian bar, it becomes a night she will regret for the rest of her life. Recurring guest star PETER DINKLAGE appears as Marlowe Sawyer, recurring guest star JACQUELINE BISSET appears as James and recurring guest star LARRY HAGMAN appears as Burt Landau.

Christian earns a fortune from a rags-to-riches client, Dawn Budge (recurring guest star ROSIE O'DONNELL), outside of McNamara/Troy, when she requests surgical makeovers for her entire family. Nonetheless, Christian continues longing for what he does not have: an honest and loving relationship. Meanwhile, James (recurring guest star JACQUELINE BISSET) blackmails Christian while forcing a terrified Michelle (recurring guest star SANAA LATHAN) to remember her past actions. Sean makes Julia a very romantic offer. And Kimber convinces Matt to move out of his parents' house.

While trying to arrange a second honeymoon for himself and Julia, Sean learns that a nanny the couple had hired, Monica Wilder (recurring guest star JENNIFER HALL), has no intention of leaving. Christian's therapist, Dr. Faith Wolper (recurring guest star BROOKE SHIELDS), reveals her obsessive, secret torment as Christian wrestles with his relationship woes. Burt Landau (recurring guest star LARRY HAGMAN) discovers the affair going on between Michelle (recurring guest star SANAA LATHAN) and Christian--and proposes an unorthodox solution. Recurring guest star PETER DINKLAGE appears as Marlowe Sawyer.

Dawn Budge (recurring guest star ROSIE O'DONNELL) returns to McNamara/Troy seeking reconstructive surgery. The ill Liz receives much-needed help from an unexpected source. Following a stroke, Burt Landau (recurring guest star LARRY HAGMAN) demands facial surgery. Kimber shuns Matt's advances but succumbs to Christian's. And Sean struggles with the man he has become. Recurring guest star SANAA LATHAN appears as Michelle Landau, and recurring guest star JACQUELINE BISSET appears as James.

A secret from Sean's childhood makes him determined to move baby Conor's surgery ahead of schedule, despite Julia's apprehension and Marlowe's (recurring guest star PETER DINKLAGE) objection. Mrs. Grubman (recurring guest star RUTH WILLIAMSON) visits Christian to make her final request for cosmetic surgery. And Conor becomes a common bond between Julia and Marlowe in their evolving relationship. MO'NIQUE ("Beerfest," "The Parkers") guest stars as Evetta Washington. Singer/songwriter BURT BACHARACH guest stars as himself and performs.

At the request of Poppy (recurring guest star ALANIS MORISSETTE), Liz's new girlfriend, Liz gets surgery to improve her appearance. When James' (recurring guest star JACQUELINE BISSET) life is threatened, she uses Christian to lure Michelle (recurring guest star SANAA LATHAN) into helping her steal another kidney within 24 hours. And Sean offers a surgical consultation to Marlowe (recurring guest star PETER DINKLAGE), who comes to McNamara/Troy hoping for a leg-lengthening procedure in order to impress the woman he loves. Recurring guest star LARRY HAGMAN appears as Burt Landau.

Sean and Christian receive an unexpected visit from the previously incarcerated Merrill Bobolit (recurring guest star JOEY SLOTNICK), who is in need of the doctors' professional services. Escobar Gallardo (recurring guest star ROBERT LaSARDO) blackmails the surgeons into visiting him in prison--and performing surgery on his face. Christian, Sean and Julia are surprised to learn that Matt is now married and expecting a child with his new wife. And Julia jeopardizes her marriage by telling Sean the truth about her relationship with Marlowe (recurring guest star PETER DINKLAGE).

In the year 2026, the adult Conor (STARK SANDS) attempts to mend his emotional wounds via a gathering of his entire family. Meanwhile, the adult Annie (JENNIFER ELISE COX) remains tormented by her own upbringing. In the present day, Julia accepts the fact that happiness means being on her own as she departs Miami for New York with her two children, leaving Sean and Christian behind for good. Recurring guest star PETER DINKLAGE appears as Marlowe Sawyer.

Suffering from loneliness himself, Sean sympathizes with a forlorn client, Diana Lubey (CATHERINE DENEUVE), and agrees to her perverse plastic surgery request. Meanwhile, Christian proposes marriage to Michelle (recurring guest star SANAA LATHAN), but his promiscuous past causes him to question his ability to make a long-term commitment to any woman. And James (recurring guest star JACQUELINE BISSET) concocts a plan to use McNamara/Troy's operating room for her own benefit. Recurring guest star BROOKE SHIELDS appears as Dr. Faith Wolper. Recurring guest star MARIO LOPEZ appears as Dr. Mike Hamoui. Recurring guest star REBECCA GAYHEART appears as Natasha Charles. Recurring guest star REBECCA METZ appears as Abby Mays. BRENDA VACCARO appears as Beatrice.

As Sean celebrates Christmas without his family, his loneliness leads him to seek solace in alcohol--resulting in possible legal action from a patient. Meanwhile, Christian receives an unexpected gift when Wilber (recurring guest star JOSIAH HENRY), who is now 3 years old, comes back into his life. And taking drastic measures to fill her holiday kidney quota, James (recurring guest star JACQUELINE BISSET) forces Michelle (recurring guest star SANAA LATHAN) to help. Recurring guest star ALANIS MORISSETTE appears as Poppy. CHARLES HAID guest stars as Reefer.

Searching his soul and exasperated by living in Christian's shadow, Sean sells his share of McNamara/Troy to Christian and Michelle (recurring guest star SANAA LATHAN). Meanwhile, Gina Russo (former series star JESSALYN GILSIG) re-enters Christian's life when she learns that Michelle will become Wilber's (recurring guest star JOSIAH HENRY) adoptive mother. James (recurring guest star JACQUELINE BISSET) ends her association with Escobar Gallardo (recurring guest star ROBERT LaSARDO) and his organ-heisting ring--and Michelle's nightmare begins. And as Matt attempts to rekindle the fire in his marriage to Kimber, Liz and Poppy (recurring guest star ALANIS MORISSETTE) come to a relationship crossroads.

Escobar Gallardo (recurring guest star ROBERT LaSARDO) seeks a cosmetic procedure from Sean and Christian for his wife, Gala (IDALIS DeLEON), who was brutally attacked by her husband's enemies. Christian and Michelle's (recurring guest star SANAA LATHAN) future together is threatened when Michelle's violent, dark past is finally exposed. With Julia and her two younger children living in New York, and Matt and Kimber expecting a baby, Sean makes a life-changing decision about his partnership in McNamara/Troy.

In the fifth season premiere, Sean and Christian settle into their new plastic surgery practice in Beverly Hills and struggle to build it from the ground up. New opportunities arise after they meet a slick Hollywood publicist who offers to help raise their reputation through the media rather than via their surgical abilities. Recurring guest star OLIVER PLATT appears as Freddy Prune, recurring guest star BRADLEY COOPER appears as Aidan Stone, guest star CRAIG BIERKO appears as Bob Easton, guest star DAPHNE ZUNIGA appears as Carly Summers, recurring guest star JENNIFER COOLIDGE appears as Candy Richards, recurring guest star PAULA MARSHALL appears as Kate Tinsley, guest star TIA CARRERE appears as Mistress Dark Pain and recurring guest star LAUREN HUTTON appears as Fiona McNeil.

Sean and Christian learn about the glamorous side of fame and the price that people are willing to pay for it. Julia visits Sean, Christian and Liz in Los Angeles with a surprise announcement. Recurring guest star BRADLEY COOPER appears as Aidan Stone, recurring guest star PORTIA de ROSSI appears as Olivia Lord, recurring guest star PAULA MARSHALL appears as Kate Tinsley, SUSAN GRIFFITHS guest stars as Joyce Monroe, MERILEE BRASCH appears as Sharon Monroe and recurring guest star LAUREN HUTTON appears as Fiona McNeil.

Sean and Julia learn more about their family dynamics as Sean resists Eden Lord's (recurring guest star ANNALYNNE McCORD) advances. Kate (recurring guest star PAULA MARSHALL) reveals a secret compulsion. Matt comes to Los Angeles with some troubling news for his fathers.

A series of unfortunate events unfold for an unlucky Dawn Budge (recurring guest star ROSIE O'DONNELL), who seeks reparative surgery from Sean and Christian. Meanwhile, Annie and Eden (recurring guest star ANNALYNNE McCORD) start to form a sisterly bond, which unnerves Sean.

While a patient inspires Sean to take his relationship with Kate (recurring guest star PAULA MARSHALL) in a new direction, Eden (recurring guest star ANNALYNNE McCORD) uses extreme methods to persuade Christian to perform surgery on a friend. Kimber and Matt fall on hard times; as a result, Kimber reaches out to a former business associate.

Christian, jealous over Sean's newfound fame, convinces Sean to tape a reality show based on their careers as plastic surgeons. However, no one expects the drama that unfolds when the cameras roll.

As Sean tries to regain his youth through his relationship with Eden (recurring guest star ANNALYNNE McCORD), a violent and traumatic event causes Julia to question her relationship with Olivia (recurring guest star PORTIA de ROSSI). Meanwhile, in an effort to better her life, Kimber makes a decision that devastates Matt.

After suspecting that something more than just their Secret Santa game is going on, Sean confronts Christian and Julia about the secret they have been keeping. Meanwhile, a hospitalized Matt bonds with his rehab counselor, and Eden (recurring guest star ANNALYNNE McCORD) tries to bond and make peace with Julia, which raises Julia's suspicions. Kimber reveals her plans for the future, and who is -- and isn't -- involved.

As Julia's health worsens, Christian falls back into old habits. Sean hires Gina (recurring guest star JESSALYN GILSIG - "Heroes," "Boston Public") as the new McNamara/Troy receptionist in order to get back at Christian. Meanwhile, Dawn Budge (recurring guest star ROSIE O'DONNELL) returns for cosmetic surgery after another unfortunate incident. Recurring guest star BRADLEY COOPER appears as Aidan Stone, recurring guest star OLIVER PLATT ("The Bronx is Burning," "The West Wing") appears as Freddy Prune and recurring guest star MAGGIE SIFF ("Grey's Anatomy," "Mad Men") appears as Rachel Ben Natan.

After Sean takes on an agent, his role on "Hearts 'n Scalpels" is expanded. Meanwhile, a suspicious Christian questions why Gina (recurring guest star JESSALYN GILSIG) moved to Los Angeles and is working at McNamara/Troy, and what her motives might be.

Christian attempts to cope in the aftermath of a death. Meanwhile, Colleen (recurring guest star SHARON GLESS - "Burn Notice," "Queer as Folk") feels threatened when another talent agency shows interest in Sean's acting career.

Eden (recurring guest star ANNALYNNE McCORD) looks to Sean for help after getting into business with Kimber and Ram (recurring guest star JOHN SCHNEIDER - "Smallville"). A group of wealthy socialites hires Christian for all of their cosmetic surgery needs. And Sean discovers another side of Colleen (recurring guest star SHARON GLESS). DONNA MILLS ("Cold Case," "Knots Landing") appears as Lulu Grandiron and JOAN VAN ARK ("The Young and the Restless," "Knots Landing") appears as Annette Wainwright.

A television critic gives Sean a dose of the ugly side of Hollywood. Meanwhile, Matt experiences a special bond with one of Christian's patients. And the cause of Julia's ailing health is uncovered.

Tragedy strikes the McNamara/Troy family after Julia learns what has caused her ill health. A visitor from Christian's past brings some revealing news. And Sean finds the price of fame to be more expensive than it's worth.

As season five continues, McNamara/Troy faces an unexpected, serious medical crisis. Christian decides to settle down with one woman and Sean discovers a new love in a moment of extreme vulnerability.

In the premiere episode for this second segment of season five, Sean's physical and emotional well-being is greatly impacted after he survives the attack from Colleen (recurring guest star SHARON GLESS). Meanwhile, Christian gets some troubling news.

Christian and Liz grow closer when his chemotherapy makes him ill and she becomes his caretaker. Sean reconnects with his broken family.

Sean tries to deal with his feelings for Julia. Christian meets someone who gets what he is going through. PORTIA de ROSSI, JENNIFER COOLIDGE and ANNALYNNE McCORD guest star.

Matt gets jealous when Sean and Raj (recurring guest star ADHIR KALYAN - "Aliens in America") starts to develop a father/son relationship. Christian and Liz try making things work.

Sean's hiring of a new anesthesiologist leads to trouble. Kimber goes to extreme measures. BRADLEY COOPER, MORGAN FAIRCHILD and KATEE SACKOFF guest star.

Sean and Teddy (recurring guest star KATEE SACKHOFF) explore their relationship and Christian relates to a patient with a unique condition.

Christian makes arrangements to secure his family's future after he's gone. Liz prepares for the wedding. Recurring guest star KATEE SACKHOFF appears as Teddy.

Christian searches for immortality and Kimber reacts to the news of Liz and Christian getting married. KATEE SACKHOFF, ANNALYNNE McCORD and JOHN SCHNEIDER guest star.

In the sixth season premiere, Sean and Christian struggle to keep McNamara/Troy thriving in a failing economy, and enlist another surgeon to attain additional income. Liz receives life-altering news, and Matt (series star JOHN HENSLEY) and Kimber seek new, separate career paths with mixed results. Meanwhile, Sean remains distant from Teddy despite their seemingly flourishing relationship. Recurring guest star MARIO LOPEZ (Extra, Randy Jackson Presents America's Best Dance Crew) appears as Dr. Mike Hamoui.

Sean makes unusual attempts to battle his insomnia. Christian and Kimber begin a joint business venture to alleviate financial strains. A furious Liz confronts Christian and offers Kimber unsolicited advice about him. Recurring guest stars ROSE McGOWAN and MARIO LOPEZ appear as Teddy Rowe and Dr. Mike Hamoui, respectively.

Sean and Teddy (recurring guest star ROSE McGOWAN) make a surprising announcement. Sean discovers some troubling news about his daughter, Annie (recurring guest star KELSEY LYNN BATELAAN), who is in town visiting. And when a patient, Briggitte Reinholt (guest star LEE GARLINGTON - Everwood), dies, it seems to be her own fault ... but is it?

Christian struggles to understand a patient with anger-management issues. Sean and Christian learn how Matt is earning an income, despite Matt's attempts to keep it hidden. Meanwhile, Teddy (recurring guest star ROSE McGOWAN) convinces Annie (recurring guest star KELSEY LYNN BATELAAN) to go on a camping trip with Sean and the rest of the family.

Matt's crime spree catches up with him, and Julia returns from New York to help in his recovery. Sean learns the frightening truth about Teddy (recurring guest star ROSE McGOWAN). Plus, a new patient suffers from extreme separation anxiety.

Julia's mother, Erica (recurring guest star VANESSA REDGRAVE), returns newly married to a much younger man, Renaldo Panettiere (recurring guest star GILLES MARINI - Dancing with the Stars, Sex and the City [2008]), and threatens to take custody of Annie (recurring guest star KELSEY LYNN BATELAAN) and her brother. To thwart Erica's efforts, Sean and Julia present a happy and united front. Meanwhile, Christian takes to a new patient, Alexis Stone (recurring guest star CANDIS CAYNE - Dirty Sexy Money), and Dr. Mike Hamoui (recurring guest star MARIO LOPEZ) reveals his future plans with Kimber.

Both Matt and Alexis Stone (recurring guest star CANDIS CAYNE) request unusual surgical procedures from Christian. Erica (recurring guest star VANESSA REDGRAVE) discovers the horrible truth about her new husband, Renaldo (recurring guest star GILLES MARINI), and drops the custody case. And, after a lifetime of torment from her mother, Julia seeks revenge.

A medical consultation with Liz's friend leads Christian to contemplate his relationship with Kimber. Sean begins to heal emotionally after an encounter with a patient seeking perfection.

Christian's colossal financial debt leads him to deception. An unexpected visitor stirs insecurity within Christian and brings joy to Sean. Plus, Christian bonds with a young patient when he learns of the boy's adoption.

Sean experiences an ethical and moral dilemma when McNamara/Troy is requested to perform a surgical procedure on a prison inmate, Wesley Clovis (guest star ERIC STONESTREET - Modern Family). Plus, Kimber questions how far she will go to be with Christian when they receive life-changing news. Recurring guest star MARIO LOPEZ appears as Dr. Mike Hamoui.

When Sean and Christian win a prestigious award from their alma mater, Sean recalls their college years and endures past pains. Plus, a new patient who self-mutilates due to a genetic disorder 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. Plus, Kimber redecorates Sean's new apartment.

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. Recurring guest star MARIO LOPEZ appears as Dr. Mike Hamoui.

Christian has a crisis of conscience when Kimber's mother, Brandie (recurring guest star MELANIE GRIFFITH), visits Los Angeles. Complications arise as Sean prepares for his trip to Africa. Plus, a patient requires multiple cosmetic procedures after suffering an attack by a wild animal.

A teenage girl (guest star SANDRA VERGARA - CSI: Miami, Días de Santiago) seeks out Sean and Christian for answers about her late father, Escobar Gallardo, stirring tremendous guilt within Sean. Plus, 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. And 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, someone who has caused immeasurable family chaos, turns up as Matt prepares to marry Ramona (recurring guest star MELONIE DIAZ - Hamlet 2, Raising Victor Vargas). Liz reveals that she's happily pregnant.

In the series finale, Sean and Christian reflect on their loving, turbulent and decades-long relationship. Recurring guest star FAMKE JANSSEN (X-Men, Made) appears as Ava Moore.