I only just caught up on this episode and yes, what a douchebag. I kind of wish he had removed all of his lipomas so he could have deep, pock-marked scars all over, hit a major blood vessel and bleed out, and/or develop a serious infection. He said he wouldn't do it again but we all know that's bullshit.
Holy shit, you could see Russia up those massive nostrils. If she could pay for a shitty nose job, why not have the plastic surgeon remove the cyst? I got the feeling that none of these people had a family tree with a whole lot of branches and her fiance was flat out creepy.