Can You Write Off Breast Implants on Taxes?

Tax deductions can reduce taxable income, but not all expenses qualify. Whether breast implants are deductible depends on the reason for the procedure. Some cases may be considered medical expenses, while others might qualify as business-related deductions. Understanding what qualifies and how to document expenses properly is essential to avoid IRS issues.

IRS Criteria for Medical Deductions

The IRS allows taxpayers to deduct qualified medical expenses that exceed 7.5% of their adjusted gross income (AGI) under Section 213 of the Internal Revenue Code. The expense must primarily address a physical or mental condition. Cosmetic procedures, performed solely to enhance appearance, are generally not deductible unless deemed medically necessary.

Breast implants are typically classified as cosmetic surgery, which the IRS excludes from deductible medical expenses. However, exceptions exist when the procedure addresses a medical condition. Reconstructive surgery following a mastectomy due to breast cancer qualifies, as mandated by the Women’s Health and Cancer Rights Act (WHCRA).

If a physician determines implants are needed to correct a congenital deformity or repair damage from an accident, the cost may also be deductible. However, procedures performed solely for aesthetic enhancement, even if they improve self-esteem, do not meet the IRS’s definition of a qualified medical expense.

Determining Medical Necessity

For breast implants to qualify as a deductible medical expense, they must be prescribed to treat a specific medical condition rather than for cosmetic enhancement. The IRS evaluates necessity based on medical evidence and the reason for the procedure. A taxpayer must demonstrate that implants serve a therapeutic purpose, such as correcting a deformity, addressing complications from a prior surgery, or alleviating a diagnosed health condition.

Medical necessity is often determined by a functional impairment or a condition affecting physical health. Some individuals may require implants as part of reconstructive surgery following a lumpectomy or to correct asymmetry that causes chronic pain or musculoskeletal issues. In these cases, the procedure restores normal function rather than serving an elective purpose.

The IRS also considers whether alternative treatments could address the issue without surgery. If non-invasive options like physical therapy or medication could provide relief, it may be harder to justify the expense as medically necessary. However, when implants are the only viable solution to a documented medical problem, they have a stronger case for being deductible.

Documentation Requirements

Proper documentation is essential to support a tax deduction for breast implants as a medical expense. The IRS requires clear evidence that the procedure meets the criteria for medical necessity. Taxpayers should maintain thorough records to substantiate their claim in case of an audit.

Physician Recommendations

A written statement from a licensed medical professional is crucial. The physician’s letter should explain the medical condition necessitating the procedure, the diagnosis, and why breast implants were recommended. The IRS is more likely to accept the deduction if the doctor explicitly states that the surgery was required for health reasons rather than cosmetic purposes.

The letter should reference supporting medical tests, such as imaging scans or lab results, confirming the diagnosis. If the procedure was part of a broader treatment plan, such as post-mastectomy reconstruction, the physician should outline how the implants contribute to recovery. Copies of all medical records, including consultation notes and pre-surgical evaluations, can further strengthen the case.

Proof of Expenses

Taxpayers must provide detailed financial records showing actual costs incurred. Acceptable documentation includes itemized invoices from the surgeon, hospital, and anesthesiologist, as well as receipts for related expenses such as post-operative care or prescribed medications. These expenses must be paid out-of-pocket and not reimbursed by insurance to qualify for a deduction.

Bank statements or credit card records alone are insufficient; the IRS prefers itemized bills specifying the procedure. If total medical expenses exceed 7.5% of AGI, only the portion above this threshold is deductible. For example, if a taxpayer with a $50,000 AGI incurs $6,000 in qualified medical expenses, only $2,250 ($6,000 – $3,750) can be deducted. Keeping organized records ensures accurate reporting and reduces the risk of disallowed deductions.

Insurance Correspondence

If an insurance provider was involved, maintaining records of all communications is essential. This includes denial letters if coverage was not provided, as well as explanations of benefits (EOBs) detailing what portion of the procedure, if any, was covered. A denial of coverage can serve as additional evidence that the expense was personally incurred and not reimbursed, which is required for tax deductibility.

If insurance covered part of the cost, taxpayers must ensure they only deduct the unreimbursed portion. For example, if the total procedure cost $10,000 and insurance paid $4,000, only the remaining $6,000 can be considered for a deduction. Keeping copies of all correspondence, including emails and formal letters, helps clarify financial responsibility and prevents discrepancies in tax filings.

Business-Related Use Cases

Breast implants may be deductible as a business expense if they are considered an ordinary and necessary cost of earning income. Under Section 162 of the Internal Revenue Code, business expenses must be customary in the taxpayer’s industry and helpful for generating revenue. In rare cases, individuals in professions where physical appearance directly impacts earnings have successfully deducted cosmetic procedures.

One of the most well-known cases is Hess v. Commissioner (1994), where an exotic dancer, known as “Chesty Love,” was allowed to deduct the cost of her breast implants. The Tax Court ruled that her implants were a business asset because they were essential to her performance and significantly contributed to her income. The court distinguished the procedure from personal cosmetic surgery, emphasizing that the implants were disproportionately large and served no personal function outside her work.

For a deduction to be justified, taxpayers must demonstrate a direct link between the procedure and their ability to earn income. Simply working in an industry where appearance matters, such as acting or fitness modeling, is not enough. The IRS evaluates whether the expense is uniquely tied to the profession rather than providing a general personal benefit.

Potential Audit Concerns

Claiming breast implants as a tax deduction, whether as a medical expense or a business-related cost, increases the likelihood of IRS scrutiny. The agency closely examines deductions that fall outside typical tax filings, especially those related to cosmetic procedures. Taxpayers must be prepared to provide extensive documentation and justify the legitimacy of their claim if selected for an audit.

The IRS may request additional proof to determine whether the procedure was truly necessary for medical reasons or directly tied to business income. If a deduction is denied, penalties and interest may be assessed on the underpaid tax. If the IRS determines that a taxpayer knowingly misrepresented the expense, they could face accuracy-related penalties of up to 20% of the disallowed deduction under IRC 6662. In extreme cases involving fraudulent claims, civil fraud penalties of 75% of the underpayment may apply, making compliance with tax regulations critical.