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  • Alternative Character Interpretation: Julian didn’t want to get married; her actions in the series finale were completely unreasonable—she asks Sean at the last moment to sign away his parental rights to some guy he’s never met who was taking them away to London. Julian did not want to move to London, so like with everything else she shifted the blame onto Sean in an effort to make him the bad guy so she wouldn’t have to refuse her husbands proposal.
  • Awesome Music: Many of the surgery scenes have a great soundtrack, varying from classic rock to classical/opera.
  • Complete Monster (seasons 5 & 6): Dr. Theodora "Teddy" Rowe is a beautiful anesthesiologist of charm and class who absolutely charms Sean McNamara and his family. Actually a greedy Serial Killer and Black Widow, Teddy seduces wealthy doctors and murders them for their money, killing a patient who recognizes her. On a camping trip with Sean, Teddy tries to kill him along with his children, even the extremely young Connor, to obtain Sean's insurance money.
  • Faux Symbolism: AOL TV says that by the Season 6 finalenote  episode's end, "watching Wesley [Clovis] die from lethal injection brought forth all sorts of metaphors, the most obvious of which being Jesus. Wesley lay there, arms outstretched on the cross-shaped surgical table, bloodied from the staples in his stomach (his own crown of thorns), an innocent man, slowly dying for someone else's sins", and that includes the sins of Matt, Sean, Christian, the murder victim's father, the courts, and "the guy who actually perpetrated the crime Wesley was accused of." Not to mention the fact that Matt's denial of Wesley's innocence at the last moment in exchange for his own freedom could be relevant to St. Peter's denial of Jesus for the safety of his own life.
  • Fridge Logic: If Gina Russo was the one who was vandalizing Christian’s property, who destroyed his car the first time before he met her?
  • Harsher in Hindsight:
    • In the Season two finale Gina, who's had her face sliced up by The Carver, jokingly tells Sean and Christine before surgery, "I don't wanna look like the Joker."
    • Nanette Babcock wants a bypass surgery to lose weight, but Christian tells her it would be too dangerous. In response she says "I hope you get cancer".
    • Joan Rivers' appearance in season 2. First, she says "Imagine what I'll look like when I'm 90." Then she books an unscheduled operation to "kill a little time." Rivers died at 81 from complications of a botched minor surgical procedure.
  • Hollywood Homely/Hollywood Pudgy : Many of the patients are attractive by average standards, but are hideous by TV standards, especially In-Universe. (such as season 3's "Flabby Abby.")
  • Ho Yay: Christian gawping at Mark Haoumi (Mario Lopez) in the shower is a very blatant example.
  • Informed Wrongness: Erica (Julia's mother), is treated as venomous bitchy Mother-In-Law character in nearly all of her appearances, and is wailed on for aggravating Julia's sense of insecurity. The problem is, in most of her appearances, Erika is trying to get Julia to stand up for herself and be proactive instead of wallowing in a giant pool of Wangst over how unsatisfied she is with her life. Sure, she's a bitch, but a comparatively minor one considering Julia's husband regularly engages in in-your-face cheating as petty revenge. It's difficult to see her as a bad person for saying Julia wasted her life by not becoming a doctor when Julia herself feels the exact same way.
  • Moral Event Horizon: Gina holding the health of her child hostage for a more expensive Burberry
  • Nightmare Fuel: Every single scene with the Carver.
    • There's also the way Colleen Rose killed a rival talent agent. She jammed the hose for a teddy bear-stuffing machine down his throat and flicked it on, then finished her new creation by pinning two button eyes onto his.
    • In the episode "Rhea Reynolds", she is conscious during her surgery, can feel all of the pain, and screams and begs for the doctors to stop in voiceover. It gets even worse when we learn that Quentin is The Carver and that he INTENTIONALLY sabotaged her anesthesia in order to punish her for faking her attack. It's bad enough that this occasionally happens in Real Life, but the thought that someone could deliberately do that is terrifying.
  • Playing Against Type: Karen Maruyama, who plays Madam Rose in a season 2 episode, is known for comedic roles and her improv work.
  • Retroactive Recognition:
  • Rewatch Bonus: Quentin giving "Rhea Reynolds" a confused Double Take. When it's later revealed that he's the Carver, it makes perfect sense—he doesn't recognize her and is wondering how she could be claiming to be a victim. There's also his stunned reaction when Troy tells him that she inflicted her wounds herself (up until then, he was probably assuming that she'd been attacked by a copycat), the way he seems to be paying extra close attention during her surgery (wanting to know if she's in agony because of his tampering with the anesthesia), and his enraged look when she finally admits that she did it to herself.
  • Seasonal Rot: The majority of the fanbase believes season 3 was trash, whether or not it ever recovered for any period of time after that is up to debate.
  • Squick: What the show is built on. Plastic surgery is inherently kind of squicky, but this show manages to gross you out every episode. An example from the fifth season was a rejected client carrying out a DIY mastectomy with a motorized knife in the middle of a waiting room.
    • Let alone clients including:
      • An older gay man who has his boytoy go under the knife to make him look more like himself as a young man. The pianist Liberace had this done to a young lover.
      • A broker has his adopted son go under the knife to give them more of a family resemblance. Seems harmless enough, right? Then you learn he did it because his clients wanted the two to look more alike because seeing a man sodomize his biological son is more exciting than seeing a man sodomize his adopted son.
      • A lottery winner wants a list of surgeries done on herself and her daughter and husband. Including breast implants on her daughter and a penis extension on her husband. Later shocked when step-father and step-daughter try their new gifts out on each other...
      • A woman wants to look more cat like, including spots... (like several cases in the show, Truth in Television)
      • A boy who wants a moustache implant so people will stop thinking the relationship he is having with his teacher is weird looking. She dumps him for his younger brother.
    • A mild example: when Annie catches lice at school, her grandmother greets her with a big hug and rubs her head against her. If you've ever had lice, you'll itch all the way through it.
    • The "secret ingredient" in Julia/Gina/Liz' special cream.
  • Tear Jerker: The death of Megan O'Hara in season one. Don't you dare say that you didn't become teary-eyed when this happened. The lighting, the tears in Sean's eyes, Rocketman playing in the background...
    Goodbye, Scarecrow. I'm gonna miss you most of all...Remember the beginning and middle of me with you, not the end.
    • In Season 2, when Troy helplessly looks on as Wilbur's biological father takes him away.
    • Also in Season 6, the execution of Wesley Clovis in spite of his innocence that was denied and ignored by the courts and by the murder victim's father who only wants vengeance in the form of "justice" satisfied. Nothing gets this one sadder than this, with the sad music playing in the background.
    • The fact that Rhea Reynolds would be so desperate for attention that she'd be willing to mutilate herself.
  • Too Bleak, Stopped Caring: The show is full of dysfunctional, rather unsympathetic characters who grow more and more dysfunctional and unsympathetic as they (poorly) navigate a seemingly endless series of increasingly improbable, horribly disturbing situations.
  • Unintentionally Unsympathetic: When Matt’s girlfriend Vanessa broke down crying upon finding out that the woman she was in love with liked Matt it was supposed to be seen as a huge tearjerker moment. However while she didn’t make Matt try an cut off his penis’s foreskin she was the one who pushed a physical relationship only to back off. While it was because she was gay she made it seem like it was because he wasn’t circumcised which devastated him upon finding out. Later she used his feeling for her to manipulate him into a threesome between her and her girlfriend who she was afraid missed men. So Matt and her girlfriend getting together come across more as a Manipulative Bitch getting her Laser-Guided Karma.
    • Pretty much everyone in the series. It might not be that unintentional after all.

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