Is Plastic Surgery Tax Deductible?

The Internal Revenue Service (IRS) applies specific criteria to cosmetic surgeries, making their deductibility highly dependent on the procedure’s purpose. Understanding these distinctions is important for navigating tax rules and record keeping. This article clarifies general medical expense deduction rules and their application to plastic surgery.

Understanding Medical Expense Deductions

To claim medical expenses, taxpayers must itemize deductions on Schedule A (Form 1040). This is beneficial only if total itemized deductions exceed the standard deduction. For instance, the standard deduction for a single filer in 2024 is $14,600, while for married couples filing jointly, it is $29,200.

Medical expense deductions are subject to an Adjusted Gross Income (AGI) threshold. Taxpayers can only deduct the amount of unreimbursed medical and dental expenses that exceeds 7.5% of their AGI. For example, if AGI is $50,000, the first $3,750 (7.5% of $50,000) of medical expenses are not deductible; only expenses above this threshold qualify.

The IRS broadly defines “medical care” as payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. This definition includes legal medical services provided by physicians, surgeons, and dentists. It also covers costs for necessary equipment, supplies, and diagnostic devices. However, expenses solely beneficial to general health, such as vitamins or a vacation, are not considered deductible medical expenses.

Distinguishing Deductible from Non-Deductible Plastic Surgery

The IRS generally disallows deductions for cosmetic surgery unless it meets a strict “medical necessity” standard. According to IRS Publication 502, cosmetic surgery is deductible only if it is “necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury, or a disfiguring disease.” This rule clarifies that procedures performed purely to improve appearance are not tax-deductible.

Medical necessity involves plastic surgery addressing a genuine physical or functional impairment. For example, reconstructive surgery following a mastectomy due to cancer, or a procedure to correct a severe birth defect, would qualify. Similarly, surgery to repair injuries sustained in an accident that result in disfigurement would be considered medically necessary. The key is that the procedure must correct a deformity or restore normal bodily function.

Purely cosmetic procedures, undertaken for aesthetic reasons without addressing a diagnosed medical condition, are not deductible. Examples include elective facelifts, liposuction performed solely for weight reduction or body contouring, or breast augmentation for appearance enhancement. These procedures are considered personal appearance expenses by the IRS. Even if a doctor recommends a procedure, that recommendation alone does not guarantee tax deductibility; the surgery must align with the IRS’s narrow definition of medical necessity.

Specific Deductible and Non-Deductible Expenses

Specific plastic surgery procedures illustrate the distinction between deductible and non-deductible costs. For instance, reconstructive breast surgery performed after a mastectomy for cancer treatment is deductible, as it corrects a deformity resulting from a disease. Similarly, rhinoplasty (nose surgery) is deductible if its primary purpose is to correct a breathing problem rather than purely aesthetic improvement. Blepharoplasty, or eyelid surgery, may be deductible if it is performed to improve vision impaired by drooping eyelids.

Many common plastic surgery procedures are not deductible. This includes elective liposuction for cosmetic purposes, breast augmentation performed solely to enhance appearance, or tummy tucks (abdominoplasty) unless medically necessary, such as for hernia repair or to alleviate severe functional impairment. Facelifts, hair transplants, and electrolysis for hair removal are also considered non-deductible cosmetic procedures. These are viewed as expenses incurred for personal appearance rather than for the diagnosis, cure, mitigation, treatment, or prevention of disease.

Related expenses are also deductible if the underlying plastic surgery qualifies as medically necessary. These include prescription medications required for recovery, hospital or facility fees, and anesthesia costs. Post-operative care, such as physical therapy or specialized supplies like bandages, would also be deductible. Necessary travel expenses to and from medical appointments for the deductible procedure, including mileage (e.g., $0.21 per mile in 2024), public transportation fares, and parking fees, can be included. Diagnostic tests performed to determine the medical necessity of the procedure are also deductible.

Essential Record Keeping

Thorough record keeping is important when claiming medical expense deductions, particularly for plastic surgery. Taxpayers should keep itemized bills from all medical providers, including doctors, hospitals, and surgical centers. Receipts for prescription medications, medical supplies, and any related equipment are also necessary. Proof of payment, such as canceled checks, credit card statements, or electronic payment confirmations, should be retained to substantiate all claimed expenses.

For travel expenses, detailed logs should be kept, documenting mileage, tolls, and parking fees for trips to and from medical appointments. If insurance covered any portion of the costs, the Explanation of Benefits (EOB) statements from the insurance company are important to show the unreimbursed amounts. Only unreimbursed expenses are eligible for deduction.

Taxpayers should obtain clear documentation of medical necessity from their physician for any procedure they intend to deduct. This can be a letter or statement explicitly linking the surgery to a diagnosed condition, injury, or congenital abnormality. While a doctor’s note does not guarantee deductibility, it provides strong supporting evidence in the event of an IRS inquiry or audit. These records should be retained for at least three years from the date the tax return was filed, or two years from the date the tax was paid, whichever is later, to comply with IRS record retention requirements.