 Joan Alexandra Molinsky asks the surgeons to undo all the plastic surgery she ever had as actress Joan Rivers, being ashamed she started the fashion of plastic surgery, especially to her lovely loving grandson Cooper, and pointing out it s a superb publicity stunt for her and the surgery firm. Ava says even besides Matt in bed, she ll never be happy again as long as people judge her; he proposes to start again in Paris and promises her anti-depression drugs- Christian surprises him stealing and sees trough his pretense it s for him; when he confronts her, she dares him into sexual power play, but he suddenly walks out during a fuck and tells Sean Ava is a male transsexual, which explains his shopping list for Matt who risks irreparable psychological damage if he finds out. The serial slasher s victims seem butchered even worse; it gives Sean nightmare hallucinations, as if talking to Colombian drug mafioso Escobar Gallardo who says he must kill the slasher, so he gets a better security firm. Adrian buys a gutting knife. The surgeons fly to Cara Nelson in Baltimore, searching the only surgeon who could have done a perfect sex change on Ava 17 years ago, pretending she s their patient, and learn her file was passed on to a colleague, retired Dr. Barett Moore, who now breads orchids and tells them Avery Tanner was a pretty gay boy who actually lusted him enough to choose a sex change, but the following marriage was a lie despite Adrian s birth. Julia tries threatening Ava to back off, and learns her price is the finishing touch-vaginal operation, which the doctors give her- with Barett, to her delighted surprise. Afterwards she tells Matt he s a hopeless boy needing a mother and refuses to go to Paris with him. Joan doesn t even like the idea of seeing what her inverse operations idea would make her look like, the computer simulation makes her change her mind- to another face-lift. While Ava is packing to leave alone, Adrian turns up; she fails talking and kissing him into joining her to Paris: being lied to too often, he stabs- himself to death. Matt is welcomed back home, Sean sleeps with a loaded revolver in hand, but the slasher surprises Christian...