Can I deduct unreimbursed medical expenses for partly cosmetic surgery?

The IRS is actually pretty clear about this in Publication 502. Medical expenses are deductible if they're primarily for the prevention or treatment of a physical or mental illness or condition. Cosmetic surgery specifically is only deductible when it's necessary to improve a deformity from a congenital abnormality, personal injury from accident/trauma, or disfiguring disease. If your procedure has both cosmetic and medical components, you may be able to deduct the medical portion if your doctor clearly documents which aspects are medically necessary. The key is getting your doctor to provide detailed documentation separating the costs and explaining the medical necessity of certain parts of the procedure. Remember that even if you can deduct some expenses, you can only deduct the total of your unreimbursed medical expenses that exceed 7.5% of your adjusted gross income when itemizing deductions on Schedule A.

I went through something similar last year with a procedure that was partly medical and partly cosmetic. I used https://taxr.ai to scan all my medical documentation and receipts, and they were able to help me figure out exactly what portions I could legitimately deduct. They have this feature where they analyze medical expense documentation and tell you what's deductible according to IRS rules. Saved me a ton of time trying to interpret the tax code myself!

Just wanted to update that I actually tried that taxr.ai site after my earlier comment. I was pleasantly surprised! Uploaded my surgical estimate which had both cosmetic and functional components for a rhinoplasty, and the analysis broke down which portions would likely qualify as deductible medical expenses. It gave me specific language to request from my doctor for the medical necessity documentation too. Super helpful for this gray area stuff where most tax preparers just say no without looking deeper.

If you need to talk directly with the IRS about this situation (which might be smart before spending thousands on surgery), good luck getting through to them. I spent 4 hours on hold last week trying to ask a medical deduction question. Then I found https://claimyr.com which got me connected to an IRS agent in about 20 minutes. You can see how it works here: https://youtu.be/_kiP6q8DX5c. Totally changed my perspective on dealing with IRS questions - was actually able to get clarity on a similar medical/cosmetic deduction question.

I have to admit I was completely wrong about Claimyr. After dismissing it, I was still stuck with my medical expense question and desperate after my third 2+ hour hold with the IRS that ended in disconnection. Decided to try it out of frustration. Got a call back about 45 minutes later with an actual IRS representative on the line. She explained exactly how to document my particular situation (implant removal that was both medical and cosmetic). Saved me hours of frustration and potentially thousands in deductions I might have missed. Sometimes being skeptical costs more than it saves.

Make sure you keep ALL your receipts and get itemized billing. I had a similar situation with a jaw surgery that was partially covered. The oral surgeon wrote a letter explaining the medical necessity of correcting my bite for TMJ but acknowledged the cosmetic improvement too. I was able to deduct about 70% of the total cost. Also remember you need to itemize deductions to claim this, so if you take the standard deduction it won't help you.

Don't forget timing matters too! For the 2025 tax year, you can only deduct medical expenses that exceed 7.5% of your adjusted gross income. So if your AGI is $80,000, you'd need more than $6,000 in medical expenses before you could start deducting anything. And you'd need enough other itemized deductions to exceed the standard deduction ($13,850 for single filers in 2024, probably higher for 2025).