Christian's plan to seek porn stars as clients backfires. Sean fixes botched surgery on a transgender woman, and discovers he has a personal link to the hack surgeon responsible. Guest starring Sophia Bush and Roma Maffia. An obese woman requests drastic surgery in time for her upcoming high school reunion, leading Christian and Grace to butt heads over her mental state. Julia comes to terms with her parenting after facing criminal charges for flushing Frisky the gerbil down the toilet. Grubman (guest star Ruth Williamson), who threatens McNamara/Troy with a malpractice suit after an accident during her surgery.
Christian is forced to play hardball with ageing, widowed socialite Mrs. Sean operates on Matt's botched self-circumcision, while Matt discovers the truth about Vanessa (Kate Mara). Sean and Christian operate on identical twin sisters, who request surgery to look different from one another. Sean tries to encourage Liz (Roma Maffia) to return to work. Matt worries about sex with his girlfriend Vanessa (guest star Kate Mara) and her possible reaction to his foreskin, leading him to self-circumcision. Julia attempts to create direction in her life, and comes to terms with her recent actions. Christian's feelings for Julia begin to affect his sex life. Grace Santiago, both professionally and personally. McNamara/Troy's new on-site psychologist (guest star Kevin Chamberlin) creates conflict between Sean and Christian, while at the same time Sean grows interested in an independent shrink, Dr. Guest starring Ruth Williamson and Roma Maffia. Aspiring model Kimber (guest star Kelly Carlson), the latest in a long line of Christian's conquests, discovers the ugly truth about his womanizing. Sean's son Matt goes to Christian when requesting a circumcision. Sean's wife Julia struggles at home with her lingering feelings for Christian, stemming from a one-night stand they had together while in college. Faith Wolper (recurring guest star Brooke Shields).Best friends since college, Sean McNamara and Christian Troy run a successful plastic surgery practice in Miami, but Christian's unethical acceptance of $300,000 from a mobster desperate for a new face threatens both their friendship and their business.
And tortured Christian redecorates his apartment after a troubling appointment with his psychiatrist, Dr. Phone sex operator Cindy Plumb (Kathleen Turner) requests that the surgeons make her voice more youthful.
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Meanwhile, Julia reveals devastating news about her unborn child to Sean, leaving him full of fear and doubt. 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). Liz Cruz (series star Roma Maffia) serves as the team's anesthesiologist. Likewise, single and promiscuous Christian is discovering that his lucrative career and good looks no longer bring him enough emotional satisfaction, as evidenced by his failed engagement to sexy and confident Kimber Henry (series star Kelly Carlson-not appearing in this episode). A seemingly conservative family man, Sean has come to realize that his financial success can't mask his family problems, including his relationship with his disillusioned wife, Julia (series star Joely Richardson), and troubled son, Matt (series star John Hensley). Christian Troy (series star Julian McMahon) run McNamara/Troy, a prominent South Beach, Florida, practice.
Sean McNamara (series star Dylan Walsh) and Dr. "Plastic surgeons, best friends and business partners Dr.
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