With April 15th rapidly approaching, it seems appropriate to discuss the deductibility of some types of plastic surgery. First a disclaimer: we are plastic surgeons, not accountants. Please consult your tax advisor before taking any deductions for plastic surgery based on information provided in this article.

Medical Expenses Tax Deduction

According to IRS Publication 502, in order to deduct medical expenses they “must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to
general health, such as vitamins or a vacation.” (On the last point, see our blog on medical tourism). So any money expended to cover a medical insurance deductible is tax deductible.

Plastic Surgery Tax Deduction

There are some plastic surgery operations where the individual might not meet insurance company criteria and hence may not be paid for by the patient’s insurance. Chief among these is probably breast reduction surgery for a woman with back pain secondary to large breasts. Insurance companies set their own rules including weight of breast tissue that needs to be removed based on a woman’s height and weight. If
a woman with back, neck, or shoulder pain had to pay for breast reduction surgery out of pocket, she should be able to deduct the cost of the surgery on her tax form.

Now what about cosmetic plastic surgery? According to the IRS “you cannot include in your medical expenses the amount you pay for unnecessary cosmetic surgery”. Examples that Publication 502 frowns upon include “face lifts, hair transplants, hair removal (electrolysis), and liposuction.” However, medical expenses for cosmetic surgery do pass muster with the IRS if “it is necessary to improve a deformity arising from or directly related to, a congenital abnormality, a personal injury resulting from and accident or trauma, or a disfiguring disease.

Then there is the case that has reached epic proportions (pun intended). Cynthia S. Hess, a “self employed professional entertainer and exotic dancer”, known by the stage name, “Chesty Love”, underwent implantation
of custom-made silicone breast implants that increased her bust size to 56N (not a misprint). She attempted to depreciate the cost of her implants on Schedule C of her 1040 as a reasonable and necessary “stage prop”.

The United States Tax Court (Docket No. 11036-92S) in 1994 ruled in favor of Ms. Love stating that “her freakishly large breasts” were “part of her costume.” Whereas clothing, hearing aids, and personal
grooming, even when they help promote one’s business are not depreciable as they benefit the individual, getting 56N size breasts was not done for “the convenience, comfort, or the economy of the individual in pursuing [her] business”. It seems then, that in the eyes of the IRS – you either go big or go home.