As the New Directions group gear up to practice for Nationals, one of Finn's bad dance moves hits Rachel in the face and breaks her nose. The doctor tells her that this might be a good opportunity for her to fix her deviated septum. Rachel is hesitant at first for fear that the procedure may affect her singing but the doctor assures her that is only a myth and she begins to consider it. At the choir room, Rachel tells them that she's considering having the surgery and Mr. Schuester says that it's risky. Rachel says she's happy with the way she looks but would like to fix her septum and it's an opportunity for her to have a more demure nose, like Quinn's. Santana keeps it real and says everybody has something about their body that they'd all like to change. Will talks to Emma about his students' insecurities. He wants his students to love them for who they are. Will helps Emma scrub grapes and help her work through her OCD but suggests that she work on trying to fix it. She tells Will that while she may not be born this way, this is her life. Will is inspired by her comments to use Lady Gaga to teach his students to accept themselves.
Santana believes that she should be prom queen. If she wins prom queen, she'll be able to win Brittany back but she needs someone with power at the school in order to get the votes. Getting the jocks on her side would completely seal the deal and which jock has the most power? Karovsky. While at coffee with Mercedes, Kurt and Blaine, she realizes the other key to votes. If she can convince Kurt to come back to McKinley high, she'll be a hero.
Will brings everyone into the room to learn about acceptance. Mercedes says that they all accept each other. Will tells them that the point of the assignment is for them to accept themselves. He tells them that they'll be performing Lady Gaga's "Born This Way." Emma is there to help with costumes – they will each wear a white t-shirt with a word or phrase on it of something they are ashamed of or cannot change. Emma's shirt reads "Ginger."
Lauren walks down the hall and has eyes on the prom queen tiara. Puck tells here that they're not real jewels anyway. She tells him that she hasn't had a tiara on her head since she won her last pageant as a toddler. Since she started to grow and find a love of chips, she "no longer looked the part." Puck tells her he'll help her get her dream.
Rachel brings Quinn with her to the surgery since she would like Quinn's nose. Rachel hesitates and says she'd like to see what she would look like after the surgery before going through with it. The two of them sing "Unpretty" as part of their glee club assignment. Quinn approaches Lauren about her run for prom queen. She tells her that the rest of the school will think it's a joke which may cause her to win and be even more than an outcast than she already is. Lauren tells Quinn to bring it.
Santana meets Karovsky for coffee and tells him that she knows that he is gay. He gets defensive about it but eventually listens to Santana after she tells him that she also plays for the same team. She says that they need each other to be the other's beard. They'll date, run for prom king and queen and rule the school after they win. Finn is upset that Quinn is helping Rachel change her nose. Quinn points out that all their fights seem to be about Rachel when Finn is actually dating her. He comments that Mr. Schue has a point with his lesson this week but Quinn doesn't seem to agree with this week's lesson. Rachel brings photos of her nose job mock-up and shares them with the glee club. Tina announces that no one is on board with her on this decision and all of Rachel's self-loathing has helped her see the light in her own Asian beauty. Finn tells her she shouldn't do it because she's beautiful, much to Quinn's dismay, but Rachel has her mind set. She wants to go through with the nose job.
Will tells Emma that her Ginger t-shirt was a cop out. If she doesn't embrace her OCD she can't really teach the kids at accepting themselves. He realizes though that Emma is a master of deflection. Principal Figgins bring Karovsky into the glee club in order for him to apologize to everyone. He credits Santana for helping him see the light about what happens to people when they are bullied. She tells everyone that the glee club is not complete without Kurt so she took it upon herself to rehabilitate Dave. She tells them that in that time they fell in love and started a new club called "the Bully Whips" made to stop bullying in the halls. Karovsky wants to make amends with Kurt.
Kurt's dad doesn't believe that Karovsky is genuine in his apology. Karovsky's dad tells Mr. Hummell that while he did not believe his own son at the time of the incident, he believes his son now is changed and back to being the son he knows. Kurt speaks with Karovsky alone and corners him for the truth. He tells Kurt the truth about Santana's plan. Kurt agrees to come back as long as they start a chapter of PFLAG – parents and friends of lesbians and gays. He tells Karovsky that he doesn't need to come out but he needs to be educated.
Puck appears in the women's bathroom to talk to Rachel about her nose job. He tells her that her nose has been passed down from one person to another for many generations. He just wants one hour of her time to show her something. Kurt celebrates his return to McKinely High. Mercedes surprises Kurt by having Blaine and the Warblers meet them on the steps and bid him goodbye with a song, Keane's "Somewhere Only We Know" bringing Kurt to tears. Kurt sings a song during glee practice to celebrate his return.
Lauren confronts Quinn in the hall by calling her "Lucy" and asks to speak with her privately. She had dug through Quinn's personal record in the school office and discovered that Quinn had transferred from another school to McKinley. Quinn admits that this is no secret but Lauren continues to say that the school had no record of someone named "Quinn Fabray." There was a "Lucy Q. Fabray" however that looked exactly like Quinn, but 70 pounds heavier and with a bigger nose. Quinn stopped using her first name because kids called her Lucy Caboosey. Lauren had already made up posters with Quinn's old photos and plastered them over the school.
Puck takes Rachel to the mall where Kurt is waiting. He tells her that Barbara Streisand had fame and power despite her nose. If Rachel got a nose job, she'd be insulting Barbara's legend. They break out in dance at the mall, flash mob to "Barbra Streisand."
Emma seeks counseling for her problem but spends the majority of the time of her session disinfecting the chair and has little time to talk about her problem. The counselor says that she has a severe case of obsessive compulsive disorder and that it's keeping Emma from who she's supposed to be. Emma says she's ashamed of her problem. Her counselor prescribes a drug for her and says she'd like to see her again in a week. Later, Emma struggles with the decision but takes a dose of her medication.
Lauren's campaign to take down Quinn with the posters failed. The old school photo actually inspired more people. Quinn admits that she's actually admires Lauren for walking around the school and owning it without having to change her identity.
Brittany shows her glee shirt to Santana which reads "I'm with Stoopid" while Santana's reads bitch. Brittany had another shirt made for Santana which said "Lebanese" though it meant to say "Lesbian" but Santana rejects it. Brittany is disgusted with Santana's new relationship with Karovsky. Santana is still hurt by Brittany's rejection after telling her that she loved her but Brittany said that if she truly did love her, she'd put the shirt on and go dance with her. Mr. Schuester reveals his shirt which said "Butt Chin." Rachel shows up and admits to the group that she canceled her appointment though she still can't dance while her nose heals. Everyone gets together to perform Lady Gaga's "Born This Way" with the exception of Santana, who watches from the audience.