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As tax day is upon us, many are pondering what deductions of expenses they can and should take. In that spirit I occasionally will get asked by a patient whether the costs from their plastic surgery are tax-deductible. Most are joking of course but a few I think are serious. As I am a plastic surgeon and have no knowledge about tax law, I recommend they ask a tax expert, lawyer or accountant, about their filing questions.

It would be hard to imagine that any type of cosmetic surgery would ever be deductible, but apparently there have been a handful of patients that have been able to take their procedures as a legitimate expense. In an article that appeared today in the journal Plastic Surgery Practice written by a tax expert, several successful tax cases were reviewed. One case was an exotic dancer whose breast implants were so large that were considered a legitimate expense to benefit her career. The other was a case of transgender surgery as the underlying condition was deemed medical in origin due to the diagnosis.

According to the article and the tax experts, cosmetic surgery may be considered a deduction if it satisfies two criteria. It must be a condition of employment and that the procedures do not create benefits for everyday use. In addition while partial deductions can be taken for expenses paid for medical care, cosmetic surgery is specifically excluded unless it is considered corrective. (I assume this falls into the classic distinction between what we as plastic surgeons call reconstructive vs. cosmetic) This would appear to mean those phsyical deformities that emanate from either congenital, traumatic or disease origins. They cite the most notable example of the difference between placing implants and other procedures for elective breast augmentation (cosmetic) vs that of re-creating a lost breast from cancer. (reconstruction) Another example would be the difference between a typical tummy tuck vs that of an abdominal panniculectomy due to the differences in medical symptoms that the pannus causes.

As a plastic surgeon, it appears that the tax distinction between pure cosmetic surgery and that of reconstructive surgery is very similar as to how medical insurance determines coverage of specific plastic surgery procedures. But the best answer for that comes from the patient’s tax advisor.

Dr. Barry Eppley

Indianapolis, Indiana

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