This is an episode unlike any other, dealing with procedures that are a little less common than a nose job. First, we meet a 19-year-old West Virginia woman who travels to New York to get a labiaplasty from Dr. Alter in order to reduce the pain and irritation caused by the size of her labia. Then we meet a transsexual patient of Dr. Alter's who is in the last stages of transitioning from female to male. Finally, porn star Tabitha Stevens--who appeared on the show in the first season--invites us along as she gets her anus bleached. Yes, you read that right. Think we can't top her bottom? Then watch as Dr. Rey delivers some surgical strikes in a tae kwon do smackdown.