Christian discovers that Gina (Jessalyn Gilsig) is recruiting character witnesses for the custody trial, including Kimber (guest star Kelly Carlson). Sean and Julia are shocked when Annie (guest star Kelsey Batelaan) enters early puberty. A young man, Elias (guest star Michael Robert Brandon), who cannot produce hair follicles on his body, requests hair implants. The operation is a success, and Christian decides he's the best person to give her an orgasm. A Somalian woman wants a clitoral reconstruction after undergoing genital mutilation. Gina (Jessalyn Gilsig) tells Christian she wants another baby, and wants him to be the birth father.

Ava suggests that Erica (Vanessa Redgrave) is at the root of Julia's problems and should be cut out of her life.

He also encounters Ava Moore (guest star Famke Janssen), a life coach, and recommends she talk to Julia about her recent stress. Sean discovers that Julia has been faking her orgasms, and asks Christian for sex advice. Guest starring Vanessa Redgrave, Orla Brady and Jessalyn Gilsig. Matt discovers that Henry (guest star Andrew Leeds) has been arrested for raping Cara Fitzgerald, and has informed the authorities about the hit-and-run Matt was involved in. But their friendship harbors a dark secret.Д¬hristian breaks his nose on a woman's vagina after she sneezes during oral sex, but is worried about Sean correcting it due to his hand spasms. A middle-aged woman (guest star Romy Rosemont) and her gay best friend (guest star Chris Diamantopoulos) come to McNamara/Troy, the woman seeking corrective surgery after being shot in the face nine months ago.

Erica and Christian have a history: they slept together at Sean and Julia's wedding. Julia's mother, Erica, comes to Miami wanting a face lift just before she starts promoting her new book. Gina (guest star Jessalyn Gilsig) tries to keep baby Wilber away from Christian, who later discovers that Wilber's nanny (guest star Portia Dawson) has been drugging him to keep him asleep. Sean turns 40, and has begun to experience spasms in his hand which affect his surgical skills.

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