Elle Harrison is back! She and her pals Jen, Becky and Susan travel to Mexico where Jen has scheduled cosmetic surgery, after which she will recover in a plush hotel suite. Soon after they arrive, Elle sees the woman in the suite next door fall from her sixth floor balcony. When the room is later occupied by another patient, Elle finds her brutally mutilated body on that same balcony.

Their doctor also takes an interest in Elle; a woman staying at the hotel asks Elle to help her fend off a creepy stalker; a veiled woman sneaks into Elle’s suite at night, and her late husband, Charlie, reappears (or Elle imagines that he does) when Elle gets pushed under water in the ocean and nearly drowns.

As dangers swirl and intensify, Elle is forced to face her unresolved issues with Charlie, even as she races to find the connections between the murders before more patients --- including Jen --- are murdered, and before she herself becomes prey.