Plot hole: Towards the end of the episode, Mr. Alderman ties up Cherry Peck and forces Matt to cut off Cherry's male genetalia. Matt does so, and Cherry screams in pain. Later on that night (probably at least an hour later in what would be "real time"), Mr. Alderman and Matt drive to a secluded area and Mr. Alderman forces Matt to bury Cherry alive. Matt refuses, and Cherry eventually steps out of the grave and strikes Mr. Alderman with a shovel before shooting him. Cherry has the same clothes on, but is in no sign of pain, or is even bloodied from the earlier trauma. It is safe to assume that neither Matt nor especially Mr. Alderman would have driven Cherry to any hospital, nor would any hospital even have let her out in an hour or two's time after an injury like that.
Plot hole: At the end of the episode when Dr. Troy is trying to get Father Shannon to confess to raping the boys, he eventually sticks a scalpel in Father Shannon's thigh, causing bleeding and ultimately making him confess via immense pain. A few minutes later, we see Father Shannon kneeling at the altar repenting/praying his final goodbyes before being escorted away by the police. We see no evidence of pain or blood, etc. Finally, Father Shannon's crimes aside, wouldn't Dr. Troy have been in some form of trouble himself for stabbing somebody?
Plot hole: By the end of Season 3, it is revealed that Dr. Costa was the Carver. It is important to also note that the first introduction to the Carver came around mid-Season 2, and there were more than a handful of victims - including Dr. McNamara himself - all in the Miami area. One huge discrepancy during that initial time period though is that Dr. Costa was living in Atlanta, running his own plastic surgery firm (we know this because Julian flew him in from Atlanta to work on Dr. McNamara). While not impossible, it just doesn't seem logistical for Dr. Costa to commute back and forth from Atlanta to Miami to commit these crimes, all while still working/running his practice in Atlanta, especially in such short spurts of time.
Answer: It's a computer graphic.