Two partners in a Miami plastic surgery practice, one a sexually liberated playboy, the other a devoted yet frustrated family man find themselves caught up in a web of intrigue when a desperate drug cartel member comes to their doors.
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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. 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. 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. 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 behaviour towards women in general. Meanwhile, Sean is invigorated after an encounter with a patient, Megan O'Hara, a chiropractor going through a divorce. And Matt's ex-girlfriend, Vanessa Bartholomew, asks for his help to revitalize her relationship with her new girlfriend, Ridley Lange.
Julia walks in on Matt having sex with both Vanessa and Ridley, and demands an intervention with Ridley's and Vanessa's parents. 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 favour to Julia, Christian terminates Jude. And Christian and Sean operate on a man who needs his oversized breasts reduced in order to gain admission to more swingers' parties.
While driving his friend Henry home, Matt looks away from the road and strikes a 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.
As the doctors' nurse, Liz Winters, consults with male-to-female sex-change patient Sofia Lopez, 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.
Christian's chronic client Mrs. Hedda Grubman, a shallow older woman who is addicted to cosmetic surgery, brings her rich, elderly fiancé in for penile surgery while she receives genital rejuvenation of her own. Mrs. Grubman is later shocked when her fiancé leaves her for his faithful longtime assistant, who is proud of her wrinkled yet beautifully natural looks.
After operating on a woman, Montana Caine, 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.
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, 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.
In the season finale, drug lord Escobar Gallardo's 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, is especially stinging to Christian. 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.