McNamara/Troy's new psychologist, Dr. Pendleton, enters into the operating room. He questions Sean and Christian about what they are doing. Sean explains that they are repairing a woman's breast implant because her abusive boyfriend ruptured it. He also says they are doing it pro bono. Dr. Pendleton sees the breast and passes out.
Sean and Christian have a consult with a pair of twin sisters, Mandi and Randi. They want to look different from each other and are tired of people confusing them from each other. Sean believes they should speak with Dr. Pendleton. However, Christian tells Sean that the girls already have a letter from Dr. Grace Santiago. She recommends the surgery.
It is the next morning and Matt is eating breakfast. Sean enters and gives him a condom so that he can hide his uncircumcised penis from his girlfriend. Julia sits down at the table and Annie tells her that she is going to make posters for Frisky, her lost gerbil. Julia becomes visibly upset. Sean asks Julia what all the baskets are for and Julia explains that she and Suzanne are making gift baskets. Sean and Julia get into a fight.
Christian goes to a tanning salon. While there, he meets Jo. It doesn't take long for Christian to get what he wants. Jo starts making out with him. Christian cannot get hard. Jo tries other ways to make him hard but Christian keeps hearing and seeing Julia. He leaves immediately.
Sean meets with Dr. Grace Santiago to go over Mandi and Randi's case. She says that it is essential that they get a singular identity. She explains how they both lost their virginity to an older man. Sean and Grace have lunch together.
At the house, Matt and Vanessa start making out. Vanessa tells Matt that she is "ready". Matt goes to put on a condom but Vanessa says she wants to see it first. He lets her. After she sees it, Vanessa only wants to make out.
Sean meets with Liz at the office. He apologizes and offers to double her salary if she will return. Sean realizes that he is not happy at home. He starts to pack his things. Julia asks where he is going. They get in another fight and Sean leaves.
Sean tells Christian that he moved out to save his marriage. Christian thinks that since Sean is now single, he should go "get some major booty". They operate on the twins. Sean does Mandi's operation while Christian does Randi's.
Julia and Suzanne are talking about their gift baskets and their husbands. The plumber is working on the clogged toilet. He leaves the bathroom and approaches Julia. He shows her a dead gerbil, Frisky, that was flushed down the toilet. Julia confesses that she killed Frisky. The plumber and Suzanne look at her disgusted.
Christian brings Matt to a strip club. He wants to build Matt's confidence by getting him to have sex with a stripper. Matt turns down Christian's offer. Christian then goes to the back room with a dancer, Avanti. She tries to get him hard but it isn't working. Christian again sees Julia. Avanti questions why Christian isn't hard. He pushes her off and tells her she is ugly and needs work done. Christian then goes on to list all of the surgeries she should have done.
Sean and Dr. Pendleton do a consult with Mr. Brancato. Later, Sean explains to Christian that Brancato has a thin penis and would like it widened. He doesn't think they should do it. Dr. Pendleton thinks it will raise Brancato's confidence and he approves the surgery. Christian and Pendleton go for a jog. Christian explains his problem with getting hard and Pendleton gives him some advice.
Christian visits Julia to talk about their past. Julia breaks down and Christian comforts her. He then invites her to his place later that night.
Matt goes on the Internet and looks up ways to do self-circumcision. Christian goes to the hospital to check on the twins. Mandi says that the male nurse didn't pay attention to her. The twins want to go back to the way they were. Sean meets with Grace again. This time, Sean hits on her. She immediately turns him down and leaves.
In the operating room, Christian asks Sean how he'd feel is Julia were to date again. Sean says he would be hurt. They operate on Brancato. Christian learns for the first time that Liz is back at double salary. After the surgery, Dr. Pendleton says something to Sean and Sean fires him. Sean goes to visit Grace at work and offers her a job.
Julia arrives at Christian's apartment. She walks in to find Christian in bed with Mandi and Randi. She storms out. Christian chases after her and tells her that she should be with Sean. Julia returns home to find Sean unpacking his things. He is moving back in. Julia tries to kick him out but they make love instead.
Meanwhile, Matt drinks a bottle of red wine and tries to circumcise himself. He snips once. He sees the blood on his hand and passes out.