Sales Tax and Tax Deductions

You have been warned about the possibility of revisional surgery if an implant ruptures before its expected lifespan and the likelihood of replacement surgery at some point down the road, both of which come with an equally hefty price tag. You realize that silicone implants are associated with the future expense of out-of-pocket MRIs every few years to screen for silent leaks. But there is probably at least one hidden cost of breast implant surgery that you may not have been banking on: tax.

Why is there a tax on breast implants?

Many states have a tax on breast implants when used for breast augmentation. However, no states add a tax on implants for the purpose of reconstruction. Why? For the same reason that health insurance companies will cover the cost of breast reconstruction but not enlargement. Augmentation mammoplasty is an elective cosmetic procedure; there is no medical reason for performing it. On the other hand, a breast implant functions as a prosthesis (that is, a medical device used to replace part of the body that has been lost due to illness or injury) in reconstructive surgeries.

How much is the tax on breast augmentation?

It depends. Some states only charge a sales tax for the silicone gel or saline implants themselves; others tax every aspect, which can really add up, especially if a woman opts to have multiple procedures – such as breast lift, augmentation, tummy tuck, and others – done at the same time.  Some patients have found a creative way to circumvent paying high tax rates for cosmetic procedures: go to a different state.   Especially for women who live close to the border of another state with a major city nearby (like New Jersey and Pennsylvania) may be lucky enough to find a surgeon with offices in each state.  You could technically travel anywhere for cosmetic procedures, but remember that it will require recovery time afterwards and the tax savings may not balance out the additional costs of recovering in a medical facility instead of at home.

Can I write off a surgery on my taxes?

Surgeries done for medical reasons (for instance, post-mastectomy reconstruction and congenital deformities) may be allowable deductions assuming your total medical expenses after insurance coverage have exceeded a certain percentage of your income.  There have been a handful of cases as part of which implants for augmentation were deductible as a business expense.  However, the majority of situations will not be considered legitimate by the IRS so unless you are certain your case qualifies, don’t try to add implants to your deductions.  To be deductible, an expense would have to have the potential of producing more revenue than its cost, and you would have to discontinue use (in other words, have your implants removed) when you stopped working for that employer or shut down your business.  If being able to deduct breast enlargement on your taxes is a crucial reason for undergoing the surgery in the first place, consult a tax attorney before scheduling the procedure to avoid any financial headaches later.