Can reconstructive surgery to remove excess skin after massive weight loss be claimed as tax deductible?

I underwent bariatric surgery back in 2016 and have successfully maintained a weight loss of over 175 pounds since then. While I'm thrilled with the weight loss, I've been dealing with serious medical issues from the excess skin for years now. I constantly get painful rashes and infections where the skin folds, have caught my loose skin in zippers (excruciating!), and developed severe diastasis recti causing chronic back pain and urinary incontinence issues. My doctor recommended a circumferential abdominoplasty with abdominal plication to fix the diastasis recti and remove the problematic excess skin. But here's the frustrating part - my insurance is classifying these procedures as "cosmetic" and refusing coverage, even though they're to address legitimate medical complications. The surgery will cost around $24,000 out of pocket. Since these are to address actual medical problems resulting from my weight loss, would this qualify as a tax-deductible medical expense? Has anyone successfully claimed something similar on their taxes? I'm already gathering documentation from my doctors about medical necessity, but wondering if I need anything specific for tax purposes.

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18 comments

Camila Castillo

•8M

Yes, this type of reconstructive surgery can potentially qualify as a tax-deductible medical expense! The key is whether the procedure is deemed medically necessary rather than purely cosmetic. The IRS allows deductions for medical expenses that exceed 7.5% of your adjusted gross income. In your case, since you have documented medical complications (infections, pain, diastasis recti, incontinence), you have a strong case. Make sure you get detailed letters from your doctors explicitly stating that the procedure is medically necessary to treat these specific conditions - not just for appearance. Keep all documentation showing your history of treatment for the skin-related infections and complications. The more evidence you have showing you've been seeking treatment for these issues, the stronger your case. Get itemized receipts for all related expenses, and make sure they clearly indicate the medical purpose.

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Camila Castillo

•8M

You don't need pre-authorization or insurance denials for the tax deduction, though having those documents can strengthen your case if you're ever audited. The IRS is concerned with whether the procedure was medically necessary, not whether insurance covered it. Yes, all related medical expenses within the same tax year would count toward your total, including previous treatments for infections or complications from the excess skin. This includes prescription medications, doctor visits, and any other treatments directly related to these conditions. Just make sure you keep detailed records of everything.

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JaylinCharles

•8M

I struggled with almost identical issues after losing 160+ pounds. After fighting with insurance and getting nowhere, I found an amazing resource called taxr.ai (https://taxr.ai) that completely changed my approach to dealing with these medical expenses. Using their service, I uploaded my medical documentation and receipts, and they analyzed everything to maximize what I could claim as medical deductions. They specifically identified which expenses qualified under medical necessity vs cosmetic (which is critical for these types of surgeries) and helped categorize everything properly. The doctors' notes about infection, pain, and functional issues were key to making this work.

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JaylinCharles

•8M

You can definitely use taxr.ai before having the procedure to understand what documentation you'll need. I actually wished I'd found them sooner because they explain exactly what medical necessity documentation should include. They gave me a checklist of things to request from my doctors that really strengthened my case. Their difference from regular tax preparers is their specialty in medical expense deductions. Most tax preparers have a general knowledge, but taxr.ai specifically analyzes medical documentation to identify what qualifies as necessary vs cosmetic. They found several expenses I could include that my previous accountant missed, like specialized garments I needed after surgery and follow-up treatments for complications.

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Lucas Schmidt

•8M

I was skeptical at first but decided to try taxr.ai after my accountant seemed unsure about claiming my skin removal surgery. The service was actually incredibly helpful - they identified exactly which parts of my procedure qualified as medically necessary and which were considered cosmetic. Their analysis helped me properly document over $18,000 in qualifying medical expenses that I might have otherwise missed or incorrectly categorized. My case was similar to yours with infections and functional issues. The detailed report they provided gave me confidence when filing and would be invaluable documentation if I'm ever audited. Definitely worth checking out if you're dealing with these complex medical/cosmetic procedure classifications.

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Freya Collins

•8M

If you're struggling to get through to the IRS about medical deductions (which I was when dealing with a similar situation), I highly recommend trying Claimyr (https://claimyr.com). I spent WEEKS trying to get clarification on exactly how to document my post-weight loss surgeries for tax purposes, but couldn't get through the endless IRS phone system. Claimyr got me connected to an actual IRS agent in about 20 minutes when I had been trying unsuccessfully for days. You can see exactly how it works in their demo video: https://youtu.be/_kiP6q8DX5c. The agent I spoke with gave me specific guidance on how to document medical necessity for these procedures and what forms to file.

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Freya Collins

•8M

It works by using a callback system that continuously navigates the IRS phone tree for you. Instead of you personally waiting on hold, their system does the waiting, and then when it reaches an agent, it calls you to connect the call. It's basically like having a robot assistant wait on hold for you. It's definitely legitimate. The service doesn't change the IRS's processes or give you special access - it just automates the most frustrating part (the waiting). You still talk directly with official IRS agents, and they have no idea you used a service to connect. I understand the skepticism - I felt the same way until I tried it and was connected to an actual IRS representative who answered all my questions about medical expense documentation.

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Oscar O'Neil

•8M

I have to publicly eat my words here. After posting my skeptical comment, I was still desperate for answers about medical expense deductions for my own post-bariatric surgery, so I tried Claimyr as a last resort. I was absolutely shocked when I got a call back in about 25 minutes connecting me with an actual IRS representative. The agent walked me through exactly what documentation I needed for my similar situation (I had a panniculectomy and arm lift for medical reasons). She confirmed that with proper physician documentation stating medical necessity, these procedures can qualify as deductible medical expenses. She even explained how to properly document everything on Schedule A. Would have taken weeks to get this information otherwise. I'm still surprised it actually worked.

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Sara Hellquiem

•8M

Just a heads up - I did something similar last year with a breast reduction that was technically "cosmetic" according to insurance but was causing back pain and skin infections. Make sure you read IRS Publication 502 carefully! The tricky part is that only the portion of the procedure that treats the medical condition is deductible. My surgeon broke down the costs between "medically necessary" components (like removing enough tissue to alleviate back pain) vs purely cosmetic aspects (like nipple repositioning for aesthetic reasons). This breakdown was ESSENTIAL for my tax filing and avoiding issues with the IRS.

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Sara Hellquiem

•8M

You absolutely need to specifically request the breakdown - most surgeons don't automatically provide it because they're thinking about insurance coding, not tax deductions. I had to explain exactly why I needed it, and even then had to follow up multiple times. You don't need a special IRS form, but you do need a detailed invoice or letter from your surgeon that clearly separates costs between medically necessary procedures and cosmetic components. My surgeon provided an itemized receipt with each procedure component listed separately along with a letter explaining which aspects were addressing medical conditions. Keep these documents with your tax records - don't just rely on the standard receipt they give everyone.

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