It's been six years after the events of Repo! The Genetic Opera. Pavi Largo is presumed dead, Bella believes him to be gone and remarries Luigi while raising her 6-year-old triplet daugters Maggi, Marni and Rottie Largo while expecting her fourth child (all of which have been fathered by Pavi) a secret kept between her and Amber, and Luigi haunted by his guilt, and Pavi returns to reunite with Bella and their daughters..