Christian does a consult with Mr. Diamond, a Michael Jackson idolizer. After reviewing his history of numerous face operations, Troy sends him away. Liz informs Troy that Sean is at home, dealing with a family emergency. Mrs. Grubman approaches Troy and demands better sheets for her bed.
Julia patiently waits outside the bathroom while Sean discusses what happened with Matt. After seeing it, Sean schedules an operation later in the day, but after Matt promises to be more open with him.
At the office Troy does a consult with Nanette Babcock when Grace enters and after informing Troy of her hiring, joins in the consult. Nanette describes that she wants liposuction and the stretch mark on her chest gone and then explains that she wants to look good for her ten year high school reunion.
All of the McNamara's(except for Annie) have finished eating breakfast when Officer Stone arrives and tells Julia that she must choose between taking an animal anger management class or a $5,000 fine for flushing Annie's gerbil.
While getting prepared for Matt's operation, Christian argues with Sean about firing Pendleton and hiring Grace. When they enter the operating room Sean gets nervous so Troy does it in exchange of Sean doing Mrs. Grubman's tummy tuck.
Afterwards, Troy decides to do Nanette's operation, but Grace and Sean change his mind. When he calls her, she is looking forward to it but soon becomes mad at hearing they won't do the surgery. When Troy goes to his car he finds it vandalized.
At the hospital, Vanessa visits Matt. Troy brings it into a mechanic and he is told that it is unfixable. Sean calls and tells him that Mrs. Grubman has been put down for another appointment. Troy then calls her and asks why she set up an unapproved appointment. After much debate, Troy decides to cut her off from their business. Meanwhile, she walks through a metal detector at the hospital and after going through it again chooses to go anyway. She gets tackled by security.
Later at the office, her attorney explains that one of them left a surgical tool in her and that she is suing them for ten million dollars. Sean at first accuses Liz but soon figures out that he was at fault. Troy visits her at her house and she offers to drop the suit for a favor.
Matt, all healed, goes to Vanessa's house and finds her making out with another cheerleader and storms out.
Sean questions Julia about searching for another Frisky and then compliments her on being a good mother. Julia decides to stop blaming Sean and to go back to school. Matt returns and tells his father that sex with Vanessa was good.
Grace visits Nanette at her home and they talk but Nanette refuses to go see a psychologist. Later Sean calls and asks her to come in. Once there she expects that he will do the surgery for her but all he does is give her a psychologist's number. Troy spends the night with Mrs. Grubman and the next day she informs him that from now on all her surgeries are free. At Nanette's place, Nanette puts a gun in her mouth and shoots.