It turns out that tax day is not all bad.  First, all you procrastinators can keep procrastinating for another three days this year because taxes aren’t due until Monday, April 18 instead of on the traditional day of April 15 (you can thank an official public holiday in D.C. called Emancipation Day).  Second, most bars and restaurants offer gimmicky discounts on unhealthy food and beverages in which to drown your sorrows.  And third, I am going to give you advice on how to get a tax deduction for plastic surgery.

DISCLAIMER: Because I’m only a plastic surgeon, and not an accountant or IRS employee, don’t simply rely on this article you found in cyberspace.  If you think you have a legitimate claim to a deduction for plastic surgery (and most of you don’t), you need to get in touch with someone who actually knows IRS policies and regulations before trying this at home.

DOCUMENTATION is half of the battle.  No, scratch that.  When it comes to the IRS, documentation is the entire battle.  If you hope to deduct your surgical expenses, you’ll have to convince me, the plastic surgeon, that what you want is medically necessary.  I have to be willing to give you an opinion on that (i.e. provide a document stating such).  And since I don’t really want to tangle with the IRS on your behalf, I’m need to be 100% sure that your procedure was medically necessary.    It’s one thing for me to merely state in a factual way what was done.  It’s another matter entirely for me to give you my medical opinion that what you want is necessary.

If you are audited (and if you deduct plastic surgery expenses, you probably will be), you need to have all the paperwork that clearly states that your procedure was medically necessary.

In general, if a tax deduction is business related, then you should be able to write it off as a business expense.  If you’re a civilian, you cannot write off the cost of a gym membership or personal trainer.  But if you’re an actor or model, and your next movie or cover assignment is contingent on a certain weight or appearance, then your gym and personal trainer fees may magically become tax deductible.

Another loophole that most Americans are unaware of is that health expenses can be tax deductible.  However, the amount of money you have to spend on medical expenses is so high that the average person will not actually meet the amount of money needed in a year to actually write off those expenses.  Even though you may feel that your health insurance premiums, eye care, dental care, and other medical expenses are quite high, the total amount you need to spend in a single year can typically only be reached if you have a very high deductible, have major surgery, or have very expensive medications needed for a chronic illness.  Typically, these expenses have to exceed 7.5% of your gross income.

The IRS has stated that “You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma or a disfiguring disease.”

Interestingly enough, some transgendered patients have successfully deducted some of the costs of sex change operations because they were able to convince the IRS that being transgendered is a “disease,” with surgery being the treatment.  And in one case, an “adult” entertainer successfully sued the IRS after they denied a deduction for her breast augmentation surgery.  She convinced a court that her income relied on her breast size, which was so large that there would be no other use for them besides work.

If you’re getting something that’s RECONSTRUCTIVE, then you may be able to get a tax deduction. Basically, if you have a documented “disease,” and you need plastic surgery for it, then yes, plastic surgery will generally be a tax deductible expense.  If you pay for it yourself, and it’s a business expense, you probably have a “better leg to stand on” in case you ever get audited.  If you have a health spending account through your employer, and your surgeon can document that your procedure was medically necessary, then you are probably very safe in case of an audit.

The biggest problem is in COSMETIC plastic surgery. It’s really hard nearly impossible to justify spa trips, Botox, a breast augmentation, or other similar procedures as a business deduction.  Even if your livelihood depends on your body (athlete, exotic dancer, uhm, let you imagination run wild here), if it’s related to your appearance, it will be difficult to justify it as a business expense to the IRS.   The examples given above were more flukes than norms.

Remember, ask not what your country can do for you –  ask what you can legally deduct to help keep America beautiful.


From the IRS

Breast Augmentation/ Chesty Love (exotic dancer, her breast implants were “stage props”)

general article on plastic surgery tax deductions

Trans-gender surgery is tax deductible-  gender identity disorder is a disease, and surgery fixed it


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