Taxes won't put dent in cosmetic surgery

National Post


If you are saving up for Botox injections, cosmetic eyelid surgery or perhaps
calf implants, there's good news: Ottawa will subsidize the cost through a
medical expense tax credit.

But Quebecers should not expect provincial tax relief because the provincial
budget last month removed cosmetic surgery from the list of expenses eligible
for a provincial medical tax credit.

Under the federal Income Tax Act, an amount paid to a medical doctor normally
qualifies as a medical expense for the purpose of a tax credit. The Act,
however, is quite specific about the types of eligible expenses. It defines a
medical expense as an amount paid to "a medical practitioner ... in respect of
medical ... services."

The Canada Revenue Agency has long followed the measure that amounts paid to
a medical practitioner for surgery of any kind, including cosmetic or elective,
qualifies as a medical expense, provided a medical condition is involved.
According to the CRA, "such a condition can include the mental health of the

Dr. Jeffrey Fialkov, assistant professor in the division of plastic surgery
at Toronto's Sunnybrook and Women's Health Sciences Centre, agrees: "There is
ample evidence in the medical literature that cosmetic procedures have
beneficial effects on a patient's psycho-social well-being."

Since Botox and artecoll injections are "in respect of medical services," any
amount paid to a medical doctor for these services would also qualify as a
medical expense. The CRA has also blessed other forms of cosmetic procedures as
qualifying for the tax credit, including hair transplants, facelifts,
liposuction, rhinoplasty and breast augmentation. Even tooth bleaching will
qualify if performed by a dentist. And there's more good news: the agency has
confirmed any cosmetic surgery done outside of Canada will also qualify.

Apparently, not all taxpayers think the government should be subsidizing
cosmetic surgery, as evidenced by a 1998 CRA letter to a concerned taxpayer,
released under the Access to Information Act.

Paul Martin, then Minister of Finance, was asked by the taxpayer whether
claiming cosmetic surgery as a medical expense would constitute tax evasion. The
CRA responded since surgery of any kind, including cosmetic and elective
surgery, is usually carried out for a valid medical reason, it would not
constitute evasion. It cited the example of cosmetic surgery to reconstruct
facial damage caused by an accident, and said: "Even though personal choice may
be involved in a decision to proceed with cosmetic surgery, it is still
considered to be a medical service, as long as there is a medical reason for

Dr. Fialkov welcomes the tax relief available to his patients, but he said he
doesn't believe their ability to claim a portion of his fees plays a significant
role in the decision to have cosmetic surgery. "Most patients are unaware of the
tax benefits," he said.

That's comforting news for plastic surgeons in Quebec. Under its budget
changes, the province singled-out liposuction, tummy tucks, facelifts, botox
injections, cosmetic orthodontic work and teeth whitening. In a related move,
Quebec also capped the amount that can be claimed for eyeglass frames to a
maximum of $200 a year per person.