by Ashley Thompson

Richmond, VA has American History and Taylor Prestige. Taylor was born with a congenital breast deformity where her right breast didn't develop properly. It's called amastia and occurs in less than 1% for females. The difficulties in school were insurmountable, even causing her to drop out of the swim team because she couldn't hide her problem. She has seen two surgeons already, but has not gone through with the surgery. The first doctor told her conflicting information than her second doctor. At 20 years old she's ready for a real improvement. When she discloses to Dr. Dubrow that she would prefer size D breasts, he isn't taken aback at all. He understands that she wants opposite of what she currently has. However, he feels that D may be slightly too big, but he will do his best.

His plan is to put implants on both sides to match symmetry. First he has to address the size difference, then the droopiness and last, the is the skin laxity. Much to his surprise, he is actually able to put in D size implants... which will make Taylor very happy. After surgery Taylor is worried about the location of her implants, feeling that one implant may be too high. Dr. Dubrow calms her fears and explains that there is a period of time for adjustment so time will tell. But ultimately one size is a bigger implant so that's why it feels different. When we see her again she's rocking a bikini at the beach. That must mean she's so happy and she should be, she looks amazing.

Charlie is from Scotland but lives in SoCal, and was born without an ear. Goldenhar Syndrome is a congenital underdevelopment of the ears, nose, the soft palate the lip and the mandible. Which means no hearing. Yet he's in a band. He has only one surgery but nothing really could be done. Now that he's in his 30's and living in LA he is feeling a bit more self conscious. Dr. Nassif calls ear surgeries extremely difficult because you can never get it looking exactly right. But he wants to try a microtia repair which involves taking rib and putting it underneath he skin to carve out an ear. Then make it look like the other ear over stages. OR, there's a prosthetic ear that involves no surgery and would look EXACTLY like his other ear. Charlie loves the idea of no surgery and since they cannot fix his hearing anyways, perfect symmetry is the next best thing. They introduce him to Dr. Robert who does prosthetics for the CIA.

When we see Charlie back in the clinic for his fitting, he's understandably nervous. Once he sees the prosthetic all fears are gone and he wants in on ASAP. The instructions are: put medical grade adhesive on the back and let it dry, put the ear in place, then walk away. But it has to be removed at night. HOLY COW!! It looks so real!! And the seams are virtually invisible. You would never know he had a prosthetic. Simply amazing.

But wait, stop everything! Paul apparently has an incarcerated umbilical hernia! Guess he gets to be the next patient. Lucky for him Terry is not only a Board Certified Plastic Surgeon but he is also a Board Certified General Surgeon and he thinks Paul needs to get this fixed ASAP. For Dr. Dubrow, operating on a friend is much different than operating on someone he doesn't know. But once in surgery mode, all is absent from the mind except the procedure. First, he will make an incision around Paul's belly button, then he 'll isolate the defect and then amputate the piece of organ that is stuck then stitch him up.

During surgery he finds that it is much more significant than originally thought. If he hadn't been seen this quickly that piece of organ could have died causing septicemia. Terry also found epigastric hernia which is a defect in the abdominal muscles halfway between the belly button and chest bone. This case keeps getting more and more difficult. Recovery for Paul is in a hotel with Terry's private nurse. Fancy Pants 2.0. But all is well and they can stay friends.

What do you think Paul thinks about having his abdomen opened up and on camera? At least he'll understand what his patients go through on Botched.

Photo by: E! Entertainment