Reflecting the fact one of the episodes is about Cosmo having problems to control his transformations, this time we have a Cosmo head gag instead of a Vicky head gag. Cosmo's head was turned into Vicky's.
When Timmy, Wanda, Cosmo go to prison to talk to Anti-Cosmo, he calls Wanda "Clarice" just like Hannibal Lecter.
At the end of this episode, Anti-Cosmo says through Dr. Rip Studwell's pixie cellphone: "Don't look for me", just like Hannibal Lecter did at the end of the movie.
Leapfrog - When Cosmo transforms into a G, it is similar to Leapfrog Letter Factory in the G room.
Disneyland - The Fairy Jail's slogan, "The Unhappiest Place Off Earth" is a spoof of Disneyland' slogan, "The Happiest Place On Earth".
Cosmo tries to kiss Wanda but keeps on changing into a fork, causing him to prick Wanda.
Cosmo turning into different and sometimes incorrect things throughout the episode until the transplant.
People calling Cosmo an ignorant boob.
People mentioning face cake.
Dr. Rip Studwell saying that he has good news and bad news to the group (for the final time, he adds that he has worse news and horrible news).
It is unexplained in this episode how Timmy can see the anti-fairies because in That Old Black Magic he can only see the anti-fairies with special goggles. But, in this episode, he doesn't, and it is before Jorgen made it so humans could see anti-fairies in When Nerds Collide. It is possible that the anti-magic suits that the anti-fairies wore prevented them from being invisible.
After Cosmo pricked Wanda by turning into a fork (on purpose) for the last time, he poofed back to his normal form and Wanda's cheek was bigger than him.
When at the doctor's office, Dr. Rip Studwell told Cosmo that the only way to fix his fagiggly gland was to have a fagiggly gland transplant. Wanda said that Cosmo is an only child, but it's revealed later Cosmo has a brother named Schnozmo. However, this is most likely because Schnozmo wasn't created yet at that point in the series.
Near the end of episode, Anti-Cosmo is flying in his prison costume. However, this costume doesn't allow fairies and anti-fairies to fly. Also, Anti-Cosmo was seen changing into a cow despite wearing his prison suit.
Despite being pierced through by a pitchfork, the laundry basket doesn't leave a hole.