(2022) Are expenses for liposuction tax deductible?

Liposuction is generally considered a cosmetic treatment. This means that the costs cannot be recognised as medical expenses under extraordinary burdens. However, such procedures are not always carried out for cosmetic reasons, but often for medical reasons.

Liposuction for the treatment of lipoedema is an operation in which fat cells are suctioned from specific areas under the skin using cannulas. Lipoedema is a fat distribution disorder that occurs mainly in the thigh, buttock and hip areas, on the inside of the knees and the lower legs. This condition is better known as saddlebag phenomenon or column leg. The question is whether liposuction is always to be regarded as a cosmetic procedure, the costs of which are not tax-deductible, or whether it is a medically necessary treatment, the costs of which can be considered as extraordinary burdens.

The Baden-Württemberg Finance Court did not recognise the costs of liposuction for the treatment of lipoedema on the legs and upper arms as an extraordinary burden because liposuction is not a scientifically recognised treatment method. Such treatment costs are only deductible if the medical necessity is proven by a public health officer's certificate. This was not the case here (FG Baden-Württemberg, 04.02.2013, 10 K 542/12).

Currently, the Federal Finance Court has rejected the Finance Court's view that liposuction is not a scientifically recognised treatment method. There was a lack of logical, rational evidence. "If the Finance Court lacks the necessary expertise to assess the question of scientific recognition, it is advisable to obtain an expert opinion" (BFH ruling of 26.06.2014, VI R 51/13).

The question, therefore, is whether liposuction is a scientifically recognised method for treating lipoedema.

According to the BFH, a treatment method is scientifically recognised "if its quality and effectiveness correspond to the generally accepted state of medical knowledge. This is assumed if the vast majority of relevant experts (doctors, scientists) support the treatment method and there is consensus on the appropriateness of the therapy. This usually requires that reliable, scientifically verifiable statements can be made about the quality and effectiveness of the method. The success must be evident from scientifically sound studies on the number of cases treated and the effectiveness of the method. The therapy must have been successful in a sufficient number of treatment cases to allow a reliable assessment" (BFH ruling of 26.06.2014, VI R 51/13).

From the decision, it can be inferred that the BFH wishes to recognise the treatment costs as extraordinary burdens. The Finance Court must now clarify whether liposuction is a scientifically recognised method. The problem with this treatment method is that it is often mistaken for a purely cosmetic operation. Therefore, it is advisable to appeal against a negative tax assessment in similar cases and refer to the BFH ruling.