Will's plan to improve the glee club's dancing skills through "booty camp" results in an instant mishap when Finn's flailing accidently whacks Rachel in the face, breaking her nose. As Finn stays by Rachel's side, her doctor suggests that while he repairs the damage he could also fix her deviated septum with a nose job: "You're 16, right? It's like a right of passage for Jewish girls." Rachel insists that she likes the way she looks and would also be afraid of doing anything that could affect her singing voice, but the doctor assures her that it may even improve her ability to sustain high notes and hard-sells her on the idea.
As Rachel considers it, Will and the glee club are skeptical, but Santana suggests - not so tactfully - that they ALL have flawed features that they might consider changing ("I'm keepin' it real"). Will is adamantly opposed, insisting that the physical things they're most self-conscious about are also the most interesting parts of them. Mercedes counters that these differences are also used by others to crush their spirits.
Will debates the issue with Emma while also helping her with her OCD fixations, which leads to a discussion about how she might deal with her problem. Emma tells him, "I may not have been born this way, but there's nothing I can do about it," and her words inspire Will to reach the students through their two favorite teachers: "Me and Gaga."
Santana fantasizes that by becoming prom queen she could fool Brittany into being with her "by royal decree," but she doesn't think she has the votes - unless she can highjack the "jock block." Sam doesn't have the juice to help as her king candidate, she thinks, and she briefly considers Dave Karofsky, until she realizes that (after catching him checking out Sam's ass) Karofsky is attracted to guys.
Mercedes, Tina, and Santana wonder if they can get Kurt back on New Directions now that The Warblers are out of competition, but Blaine doesn't want Kurt back at McKinley because of Karofsky. The admission inspires Santana's new scheme: If she can deal with the Karofsky issue and bring Kurt back to McKinley, she'll be such a hero she'll be a shoo-in as prom queen.
Will assigns the students to sing songs about accepting themselves for who they are - both the best and the worst aspects - including a group number of "Born This Way" by the "queen of self-love," Lady Gaga. To that end, Emma's going to outfit the students with white t-shirts each bearing the word that makes the wearer the most self-conscious so they'll learn to wear it with pride. As an example, Emma reveals her own t-shirt, which to Will's surprise says "Ginger" rather than any OCD reference. She explains that her "ginger-hood" has haunted her all her life, and she's proclaiming it in front of everyone.
As Lauren gazes wistfully at the prom queen crown on display, Puck assures her that it's meaningless. She reveals that she hasn't worn one since she was the three-time winner of "Miss Tiara Toddler," on her way to becoming Miss Ohio until "the shoddy Zizes thyroid kicked in." Puck then promises her that she'll wear the prom queen crown, with him as her king.
Rachel brings Quinn to the doctor's office as a model nose, in exchange for her vote for prom queen, and Quinn explains how her looks typically inspire people to be accommodating to her. As they go through the doctor's analysis, both girls reflect on their genuine self-images through a fantasy mash-up of TLC's "Unpretty" and "I Feel Pretty" from "West Side Story."
Quinn is threatened when she overhears students reacting to Lauren's prom queen campaign posters - they're intrigued by seeing someone who looks like them for a change - and brings her wrath down on Lauren. But Lauren stands defiant, suggesting that Quinn's outsides don't represent what she really is on the inside. Furious, Quinn promises to make the competition personal.
Santana meets covertly with Karofsky and bluntly explains that his secret is no longer a secret. Despite his denials, she outlines his potential future: as a "late-in-life gay," he faces a life of denial, an empty marriage, and an eventual outing that will ruin his career - but she accepts it because she needs him, and he needs her. She reveals that she's gay herself, and suggests that they serve as each other's "beard" - or she'll out him. "The only straight I am is straight-up bitch," she insists.
Finn works on his dance skills with Mike, singing an up-tempo version of Sammy Davis, Jr.'s "I've Gotta Be Me," earning a backhanded compliment from Will when he's used as an example of someone who's not afraid to do something they're really bad at ("But I'm getting better, right?" hopes Finn).
Rachel is on the verge of making an announcement about her nose job decision, when she is taken aback by Tina's sharp critique. Tina admits that she's done with her own blue contacts and intends to "be the change you want to see in the world." Rachel soldiers forward, revealing computer-generated photos of her potential face post-nose job, but Puck in particular objects, noting how the girls at his temple come in looking different - and not as hot (though easier to make out with).
Will confronts Emma with his disappointment over her so-called admission, but she says it's different from the lesson he's trying to convey: she wasn't born with her OCD. Will insists that she has an acute anxiety disorder that others overlook because she functions so well on the surface, but it's keeping her from enjoying her life. He tries to get her to eat unwashed fruit with him, but she won't. He calls her an expert at deflection, working hard to help others so she won't have to face the tough work on herself.
Principal Figgins forces the unwilling glee club to hear an admission from Karofsky: he apologizes for slushie-ing each of them, and confesses to treating Kurt worst of all. Admitting his shame, he offers to earn their trust after Santana showed him the light, having him read about some of the tragic consequences to victims of bullying. Santana reveals that, because the glee club is incomplete without Kurt, she's taken it upon herself to rehabilitate Karofsky so Kurt can return and help them win Nationals - and in the process, she and Karofsky fell in love. Together they've formed a new club - the Bully Whips - dedicated to policing bullying at McKinley, and Karofsky promises to reach out to Kurt to make amends.
Kurt's dad, Burt, is not convinced that his son will be safe returning to McKinley, despite Figgins' assurance that the new club has curtailed the school's bullying problem. The bullying stopped, Burt thinks, because Karofsky was the chief offender. Karofsky's father pleads with Burt, insisting that his son has reformed. Kurt tries to reassure his dad that he's satisfied with the improvements, but he wants to speak to Karofsky alone.
When the adults clear the room, Kurt demands to know what Karofsky's angle is. When Karofsky expresses surprise that Kurt didn't reveal Dave's true orientation earlier, Kurt tells him, "I don't believe in denying who you are, but I don't believe in outing people either." Kurt insists that Karofsky owes him the truth, and Karofsky reveals Santana's scheme. Kurt agrees to the subterfuge, but only if Karofsky also helps him establish a parents-and-friends support group for gay students - Dave (who insists he's still not sure if he's gay) doesn't have to come out, but he does need to be educated. Meanwhile, Burt asks Finn to keep an eye out for Kurt, and Finn tells him he's one step ahead of him.
Puck corners Rachel in the ladies' room, asking for one hour to prove his point to her. Meanwhile, Kurt is welcomed back to McKinley with open arms, and the Dalton Academy Warblers show up to bid him goodbye with a farewell song, Keane's "Somewhere Only We Know." Kurt reflects on his happy return to the school, singing a joyous version of Barbra Streisand's "As If We Never Said Goodbye."
Lauren has a private pow-wow with Quinn, revealing that her father's college roommate G. Gordon Liddy taught her family a valuable lesson in getting intel on an opponent, and she's done her own digging into Quinn's background with Puck's help. Scouring through Quinn's permanent record, Lauren found several inconsistencies and eventually determined that Quinn was previously Lucy Q. Fabray: some 70 pounds heavier, brunette, bespectacled, and with an entirely different nose.
Friendless, taunted by the nickname "Lucy Caboosey" and hating her looks, Quinn radically changed her name and appearance before she transferred schools. Quinn says she was a miserable girl, and she's never looking back - becoming prom queen will be the capper of her transformation. But Lauren says that no one who'd vote for her will aspire to be like her anymore if they know the truth: Lauren has plastered Quinn's old photo in the hallways.
At the mall, Kurt tries to talk Rachel out of her nose job by evoking her idol Barbra Streisand, who redefined the then-prevailing standards of beauty. Not only would Rachel be letting Barbra down, but she'd also be letting down the girls to come who will admire Rachel. To hammer home his point, Kurt and New Directions launch a flash mob to Duck Sauce's "Barbra Streisand."
Emma finally meets with a psychologist, Dr. Shane (Kathleen Quinlan), but she spends most of her allotted time scrubbing down her chair. Dr. Shane suggests that there are several solutions available to aid Emma's severe condition, but she needs to deal with it seriously. "Your illness is not who you're supposed to be," says Dr. Shane. "It's keeping you from who you're supposed to be." Emma admits that she feels ashamed about her condition, but Dr. Shane's revelation about her own battle with postpartum depression appears to ease Emma in accepting into a course of treatment.
Quinn believes that her prom queen chances are over, but Finn pulls her old pre-change photo from his wallet and tells her that he prefers it to her previous one because it's the first one in which he can really see her. Then Lauren reveals that Quinn's popularity has spiked among the students who admire her for transforming herself - and she apologizes for her cruel stunt. Quinn also admits her respect for Lauren: "I had to get a nose job to walk around this school like I owned it, and you just do it."
Brittany shows Santana her flaw-proclaiming t-shirt ("I'm With Stoopid" with an up-arrow) and offers an alternative to Santana's "Bitch" tee: "Lebanese" (it was supposed to read "Lesbian"). Brittany explains that Santana's honesty about her sexuality made her proud, but Santana insists that Brittany not tell anyone. She's upset that when she told Brittany she loved her, Brittany didn't say she loved her back. Brittany tells her she clearly loves Santana more than Santana loves herself or she'd put the tee on and dance with her.
Will shows the students his t-shirt - "Butt Chin" - as Rachel says that she cancelled her surgery. She reveals her t-shirt: "Nose." As the glee club performs their version of Lady Gaga's "Born This Way," all of the students' t-shirts are unveiled (Kurt: "Likes Boys"; Mercedes: "No Weave!"; Finn: "Can't Dance"; Mike: "Can't Sing"; Artie: "Four Eyes"; Sam: "Trouty Mouth"; Tina: "Brown Eyes"; Quinn: "Lucy Caboosey"; Lauren: "Bad Attitude"; and Puck: "I'm With Stupid," with an arrow pointing to his crotch).
Joining Will to watch the rehearsal, Emma unbuttons her sweater to reveal a new t-shirt proclaiming "OCD." And in the audience, Santana watches next to Karofsky - she never joins in, but she's wearing the "Lebanese" t-shirt.