Plastic Surgeons Criticize New Tax Law : Medical: Elimination of a deduction for elective cosmetic surgery is not only “absurd,” but also unenforceable, they say

Plastic surgeons say a new law eliminating elective cosmetic surgery as a federal income tax deduction is silly and unenforceable.

Beginning today, elective cosmetic surgery will no longer be deductible as a medical expense. Lawmakers passed the proposal in hopes of adding about $270 million a year to the nation’s coffers.

“It’s an unnecessary piece of legislation--I think it’s absurd,” said Dr. Alan Gold, a Garden City, N.Y., plastic surgeon who has followed the issue closely. He said the Internal Revenue Service is in no position to decide whether a procedure is cosmetic or has some medical benefit.

Surgeons, however, have not seen a rush to complete cosmetic surgery by Dec. 31.

“I’ve only had one patient who asked to pay for a procedure this year but have it done next year,” said Gold, adding that he doesn’t think it will have any effect on a person’s desire for cosmetic surgery.

Anne Gorman, spokeswoman for the American Society of Plastic and Reconstructive Surgeons in Arlington Heights, Ill., said society members are not worried that the total volume of operations will drop.

“But we are worried that the change will cause problems with the Internal Revenue Service and insurance companies, who are often unwilling to reimburse people for cosmetic surgery,” said Gorman.

Accountants familiar with the change say they don’t anticipate a major uproar among their clients.

“If you pay for the surgery and get reimbursed, you have to include that reimbursement as taxable income,” said Stephen Kunkel, a director in the tax department of Levine, Cooper & Spiegel in West Los Angeles.

“Insurance companies may also use it as an excuse to drop portions of the policy that covers cosmetic surgery,” he said.

Edward Rosenson, a tax partner in the Century City office of Ernst & Young, said Congress changed the law because the IRS believed that there were abuses related to the tax deduction.

“People who want to have face lifts and hair transplants do it independent of the tax impacts,” Rosenson said.

He said he has one client, an actress, who spent about $25,000 on surgery and decided to deduct it as a business expense.

“She felt it would further her career, and I felt it was a defensible position,” said Rosenson. So far, the IRS has not questioned the return.

Although many people think that plastic surgeons cater primarily to wealthy celebrities, the middle class is in fact the largest consumer of cosmetic surgery, according to the American Society of Plastic and Reconstructive Surgeons.

Based on a patient survey completed in 1988, 30% of those who had cosmetic surgery earned $25,000 or less, 35% earned $25,000 to $50,000 and 23% earned more than $50,000 a year.

“If someone is going to have it done, they’ll have it done despite the cost, the discomfort and the bruising,” said Dr. George Sanders, an Encino plastic surgeon who expects to complete 70 surgeries this month.

Other surgeons point out that cosmetic surgery has become much more affordable in recent years.

“When I started practicing in 1963, a face lift and eyelids cost about the same as a new Cadillac,” said Dr. Edward Truppman, president-elect of the American Society for Aesthetic Plastic Surgery. “Now, it costs as much as a compact car--about $8,000 or $9,000.”