Mother of eight Rubi stuns Dr. Meegan Gruber when she arrives with a hip condition unlike anything the doctor has ever seen; Ashley asks to have her bat wings clipped; Jim seeks a solution for a giant neck that's swallowing his jawline.

Dr. Meegan Gruber faces the most daunting awake surgery of her career: removing a giant hanging stomach; Jason looks for a butt lift to help him scandalize all of Kentucky; a patient calls her psychic mid-surgery.

Dr. Meegan Gruber specializes in performing surgery while patients are completely awake; Derrick orders lunch while getting his "man boobs" removed; Genny has a request to get rid of both of her chins; Megan needs surgery to fix her "ballsack arms."