When Merrill is first talking to Christian, reference is made to Madame Rose, killing a girl and Merrill trying to cut Christian's face off. This all happens in the Season 2 episode Oona Wentworth.
Julia and Sean like to have make-up sex in their children's rooms: Conor was conceived in Matt's bed at the beginning of Season Three, and in this episode they had sex against the newly-painted wall in Conor's room after Julia admitted to her affair with Marlowe.
Annie in 2026 reminds Julia about the time she cut up her dolls' hands to look like Conor. This happened in the episode Blu Mondae.
When Annie in 2026 is talking about her 'emotional baggage', she mentions having a party to celebrate her first period. Her 'Princess Menses' celebration was shown in the Season 2 episode Mrs. Grubman.
When Christian is being haunted by his previous relationships, he sees Natasha Charles. Played by Rebecca Gayheart, she appeared in two episodes of Season 2: Natasha Charles and Trudy Nye. She was a blind woman who came to McNamara/Troy for prosthetic eyes. They began a relationship, but Christian's fear of commitment and intimacy led to them breaking up.
When Christian is being haunted by his previous relationships, he sees Abby Mays. Played by Rebecca Metz, the character appeared in the Season 3 episode Abby Mays. She came in to McNamara/Troy for extensive surgery and Christian said he'd sleep with her if she put a paper bag over her head, which she did!
When Michelle and Sean are arguing at the beginning of the episode, Michelle mentions returning 'to a crime scene'. When Escobar escaped in Merrill Bobolit, he left several dead bodies behind him.
When Sean first meets Faith, he mentions her coming in to McNamara/Troy for a tattoo removal. This was also shown in Faith Wolper, PhD.
Faith refers to 'the dream' where Sean and Christian were lovers– this featured at the beginning of Faith Wolper, PhD.
When Christian and Sean confront Faith, Christian mentions that he 'nailed her in this office'. This was toward the end of the season opener Cindy Plumb.
Sean asks Merrily if she knew Marlowe. Debbie Lee Carrington (Merrily) & Peter Dinklage (Marlowe) appeared together in "Tiptoes".
At the beginning of the episode, Christian mentions Sean has 'a gift from Diana Lubey', the patient played by Catherine Deneuve in the previous episode- also entitled Diana Lubey- who asked for ashes to be placed into her breast implants.
When James has the gun pointed at Michelle, she mentions that killing 'a drunk is one thing'. In the previous episode Reefer, James orchestrated the murder and organ harvest of a homeless man (also called Reefer).
When Sean and Troy are packing boxes, the two items Troy hands to Sean are packed, but reappear on the table after the next cut.
This episode has a lot of references to previous episodes and events within the show's history:
Reference is made to the Season 1 episode Antonia Ramos when Sean mentions that the titular character was a drug-mule of Escobar's whose breasts got infected by the drug-filled implants.
There are several references to the Pilot episode, with Christian mentioning getting 'a Botox shot in the dick' from Escobar (and the eventual disposal of both Silvio Perez and, later, Escobar himself).
Sean mentions Escobar shooting Liz, which happened in the Season 1 finale Escobar Gallardo and also mentions the murder of Alejandro Perez in his living room (which happened in Merrill Bobolit).
Michelle and Christian talk about the stealing of Liz's kidney (in Shari Noble).
In the final scene, the intern mentions 'the Rosenberg case' (Sean and Christian separated a pair of conjoined twins in the Season 2 episode Rose And Raven Rosenberg) and Sean's 'son's ectrodactyly operation' (in Conor McNamara)
In Aiden's first onscreen appearance, he tells Freddy "A musical episode? How gay is that? Come on, this is the kind of desperate schlock you don't do til your fifth season!"
This is a subtle dig at other TV programs, who after entering their fifth season (or after shooting 100 episodes), tend to run out of ideas and create more outlandish storylines and episodes to keep the audience's attention. It also appears to be a tounge-in-cheek reference to Nip/Tuck (a show which has always had outrageous characters and storylines) entering its own fifth season with this episode.
Christian marks Carly's portrait with lipstick to highlight areas for surgery. He did the same with Kimber in the pilot episode and Abby Mays in the Season 3 episode of the same name- although he marked their bodies with lipstick instead.
The deal that Christian and Sean strike with Hearts And Scalpels- producer credits and the occasional line- is a similar deal to one that Linda Klein (Nip/Tuck's medical consultant who plays Nurse Linda in the show) has with Nip/Tuck.
During the scene where they're touring through the studio on a golf cart, it clearly sounds like Julian McMahon was speaking with his native Australian accent.
When asked if he's worked on anyone famous, Christian says they 'almost worked on Joan Rivers once', This refers to the Season 2 finale- entitled Joan Rivers- where she came to McNamara/Troy to have her extensive plastic surgery undone (but ultimately decided against it).