Sean interviews Ellie Harkness, who wants to change her appearance to match a picture from years ago so that her husband with alzheimers could remember who she was. Sean turns her down. After he shows her out, he is served by a restraining order from Matt.
Sean goes over to Julia's apartment to confront Matt, who hadn't told her about the restraining order yet. After trying to apologize, Sean becomes angry and Julia tells him to leave.
Sean and Christian repair a woman who had cut herself. Quentin walks in and tells them that there's been another Carver victim. Afterwards, Sean tells Christian that he referred her to another surgeon. Christian talks about how much pain he is feeling from when he was attacked and raped. Sean examines him and tells him that there is no physical wounds, only emotional, apparently. Then, Christian agrees to take the case to help him with his own pain.
Ellie comes back to try to convince Sean to do the surgery on her. She takes him down to the nursing home where her husband is and he doesn't recognize her at all.
Christian and Quentin interview Rhea Reynolds, the Carver victim. She tells them that the attack has given her a lot of strength, and Christian is uncomfortable about that.
Sean decides to do the surgery on Ellie, which turns out to be pretty extensive.
Christian apologizes to Ellie about the way he acted. He reveals that he was a victim of the Carver to her. She suddenly becomes emotional, but then asks for other surgeries to make her more beautiful, like a nose job.
Family Services visits Sean's house and asks his daughter Annie a few questions. They think she is at risk because of what Sean did to Matt. One of them sees that she has bruises on her, which are from soccer, but they think Sean hurt her.
Christian talks to Quentin afterwards and says that she made the whole thing up. He said that she probably cut herself.
Julia comes down to the house to straighten things out, and she has to take Annie away because Sean can't be left alone with her until the restraining order is lifted.
Ellie is in recovery, but tries to take her bandages off early to see her new face, and undos the stitches.
In surgery, Rhea is can feel it when Christian opens up her skin, as if she wasn't given the proper anesthetic. The doctors discover that she did it to herself, because it wasn't the way the Carver cuts people. Rhea screams, but the doctors keep on going.
Rhea brings in a lawyer and eventually admits that she did it to herself to get attention, after threatening to sew Christian.
Ellie goes with Sean to meet her husband and show him her new face. Unfortunately, he doesn't recognize her and introduces her to his girlfriend.
Matt shows up at Sean's house and announces that he lifted the restraining order. He made it clear that he didn't want to have anything to do with Sean anymore. Sean tells Matt to hit him and get even, but Matt think's he crazy.
Liz tells Christian that she's sending the anesthetic to the lab for analysis. Christian tells her to test it on him to relieve some of his pain.
Sean cuts himself along his arm, trying to replace his emotional pain with physical pain.
The Carver shows up at Rhea's place and tells that she made a mess of things, and that he was going to give her real pain. He then killed her.