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.