Sage Alcazar arrived in Port Charles with one thing on her mind: revenge. A gun-toting Sage had been stalking Alexis Davis for days, waiting for the right moment to wreak havoc on her life, because Sage believed that Alexis had murdered Luis in cold-blood. However, that right moment never came for the obviously tormented teen. Alexis, who had just won full custody of her little girl, Kristina, would soon have a pretty creepy encounter with Sage. Soon after, Sage--to receive some attention--jumped off the dock and into the river. Dillon Quartermaine had seen Sage jump, and, fearing the worst, he jumped in after her and "rescued" her. However, Dillon immediately realized that Sage had jumped in for attention. Dillon took Sage back to the Quartermaine mansion and Sage was more than willing to strip in front of Dillon. However, the interruption of Dillon's girlfriend, Georgie Jones, had Sage hiding under Dillon's bed. Georgie had planned to make love to Dillon, but Dillon thought that the time wasn't right because Sage was under the bed. Sage smiled while listening to Georgie's attempts to seduce Dillon. Days later, Dillon and Sage had another encounter.
Only this time, Dillon found the gun that Sage had been hiding. Sage told Dillon that she wanted to make life unbearable for somebody, but she didn't say who. After Luke Spencer's trial, Sage confronted Alexis Davis in the empty courtroom. Sage confirmed what was obvious to the audience: she was non-other than Luis Alcazar's daughter (the man Alexis had murdered in 2002). Alexis apologized for Luis' death, but Sage didn't care. Dillon ran into the courtroom when Sage fired off shots. Sage told Dillon that the bullets were blanks, but Alexis should be aware that the day will come where the bullets in the gun are not blank. Det. Andy Capelli and Officer Lucky Spencer came into the courtroom. Lucky misinterpreted the reason Dillon had a gun and fired at him. Dillon was shot in the arm. Sage did show compassion towards Dillon when he got shot, but she was arrested for her crime. Down at the police station, Sage's uncle, Lorenzo Alcazar, showed up and took Sage to his house. Sage begged Alcazar to take her in, but he felt that he didn't have time to take care of a teenage girl. Sage promised that she'd take care of the apartment and she did manage to convince Alcazar to let her stay ONLY if she stayed away from Alexis Davis.
Sage continued to pursue Dillon, especially after finding out that Georgie was extremely jealous of her. She convinced her uncle to make Dillon her bodyguard. Soon after, Dillon was forced to take Sage out of the country to keep her safe. While away, Sage got Dillon drunk and he passed out. When Georgie called, Sage pretended that she had bedded Dillon. But Dillon was able to convince Georgie it wasn't true. When Dillon's mother Tracy returned to town, she immediately tried to keep Dillon and Georgie from seeing each other. She promised Georgie to make Dillon stop working for Alcazar if Georgie stopped seeing him. So Georgie pretended to be mad at Dillon and broke up with him. Heartbroken, Dillon fell into bed with Sage. A gleeful Tracy set it up for Georgie to discover Dillon with Sage. Dillon tried to explain but Georgie refused to listen. Sage told Dillon that she had been a virgin and that their night together meant something to her. She was crushed when he said he wished it had never happened. She ran to her uncle and begged him to take her out of town, but he told her she couldn't run from those she cared about. Sage then decided to stay and pursue a relationship with Dillon. However he continually rebuffed her attempts to get close to him again.
When Georgie continually dropped hints that she had moved on with another guy, Dillon began showing interest in Sage. Sage soon smelled something foul about Georgie's new boyfriend since no one had ever seen her with him. She tried to call her bluff by getting Georgie and her boyfriend Tom elected as the kind and queen of the high school dance. But a guy arrived just in time to pretend to be her boyfriend. A fire erupted in the hotel the night of the dance, trapping the two couples in their hotel rooms. Fearing the end, Georgie confessed her lies to Dillon. In the days following the fire, Sage and Dillon had a few brief moments of happiness together before Dillon began getting close to Georgie again. Tracy encouraged Sage to seduce Dillon and get pregnant. Sage refused and tried her own tactics to keep Dillon. But Dillon broke up with her anyway and got back with Georgie. So Sage agreed to help Tracy smear Georgie's name so Sage could get Dillon back. Sage became a hospital volunteer to get at Georgie. Tracy made Sage take naked photos of Georgie showering in the locker room and then they posted the pictures from GH to make it look like Georgie was selling nude photos of herself on the Internet. Sage hoped this would discuss Dillon enough to bring Dillon back to her. But when Dillon found out, he immediately blamed her and then his mother. Tracy admitted her involvement and then blackmailed him into casting the deciding vote to make her CEO of ELQ. Sage's hopes of reuniting with Dillon were dashed when he declared he didn't want anything to do with her. Sage immediately ran to the Quartermaines' and spilled Tracy's scheme to the family who immediately declared it against the company bylaws. Tracy was booted out of her new CEO position.
A few weeks later, at Tracy and Jax's engagement party, Alcazar brought Sage to make up with Dillon. Then Ned approached Alcazar to invest in the recently revived L&B in order to spite Tracy for what she did to Sage. Alcazar agreed as long as Sage could audition to be a singer. Sage was very excited, especially since Dillon was already working for Ned at L&B on music videos. Georgie was not happy about the new arrangement especially given how Sage was fawning all over Dillon. She decided to arrange a harmless accident to humiliate Sage and get Dillon pulled from the project. But Sage got injured and strained her vocal chords from screaming. Lorenzo was furious and removed his financial investment. Sage vowed revenge on Georgie by breaking up Dillon and Georgie. Fortunately Sage healed fully and returned to L&B. She began seeking her revenge by requesting that Dillon work on her video but without Georgie around.
While Sage was out of commission, a hauntingly beautiful voice arrived in town. Ned's daughter Brook Lynn had run away from home. Her mother Lois showed up to find her and Ned convinced them both to stay and Lois to run L&B again. Lois thought Sage was a good singer and wanted to promote her. When Sage partnered with her new friend Trent to try to record behind Lois's back, Lois cut them off by having Sage sign a recording contract.
Sage didn't get along with Brook very well since Brook was constantly complaining that Sage's uncle was not good enough to be involved with Lois. Sage continually defended her uncle to Brook. But when a contest was announced to find the next big girl band, Sage grouped with Brook, Georgie, and Dillon, who dressed in drag, to try out for the competition. Sage was crushed to hear that the group was only supposed to launch a future solo career for Brook. She told Trent she planned to blow up the girl band deal. When Brook wanted to hold a séance to communicate with Lila beyond the grave, Sage saw her opportunity to scare everyone. With the help of Trent, she made it appear that Lila's spirit had come back and was moving things around. Then she pretended that she had been stabbed. When the others found out they yelled at her. She yelled back and taunted Georgie that Dillon still wanted her. Georgie had finally had enough and locked Sage in the basement freezer. Felicia found out and the whole group went downstairs to get her out. However, they found Sage dead instead. Georgie blamed herself for locking Sage in the freezer, and Tracy overheard her "confession." She called the cops and Mac showed up. He played out scenarios with Emily, Nikolas, and Faith each as the murderer. Meanwhile, Faith had already told Justus that she had found Sage dead earlier. Justus wondered what Faith was leaving out. But the actual culprit turned out to be Mary, who was after Emily and killed Sage by mistake. Concerned about Lorenzo's reaction to the news, Brook suggested that Lois break the news to him. When Lois informed Lorenzo of Sage's death, he was torn up. He bounced back and forth between anguish and rage at those responsible. He demanded justice from Ric and when Ric voiced skepticism over being able to put Mary away for Sage's murder, Lorenzo physically grabbed Ric and promised to avenge Sage's death himself. Lois later presented Lorenzo with a photo of Sage that had been taken for the studio. He was grateful to her.
Afraid that Lorenzo would come after Georgie for locking Sage in the freezer, Dillon tried to fall on his sword for her. But Lorenzo told Dillon he was grateful to him for being Sage's friend and for getting to know her. He also gave Dillon a letter Sage had written for him but never sent a few weeks before. Dillon read the letters and the poem accompanying it to Brook, Georgie, and Lucas. All of them realized they should have given Sage more of a chance.