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.