Are expenses for liposuction tax deductible?

Liposuction is often performed for cosmetic reasons. Purely cosmetic procedures are not tax-deductible as medical expenses. However, it may be different if the liposuction is medically necessary, for example, to treat lipoedema.

Liposuction for lipoedema may be deductible

Lipoedema is a chronic fat distribution disorder that can occur mainly on the legs and arms and is often associated with pain, swelling, and sensitivity to pressure.

The Federal Fiscal Court (BFH) has ruled that liposuction to treat lipoedema has not been considered a scientifically unrecognised treatment method since 2016. This applies regardless of the stage of lipoedema (BFH ruling of 23.03.2023, VI R 39/20).

The treatment costs borne by the patient can therefore generally be considered as extraordinary expenses under § 33 EStG.

The official income tax manual 2025 for § 33 EStG takes this BFH case law into account.

Is a public health officer's report required?

For liposuction to treat lipoedema, a public health officer's report issued before the treatment is generally not required.

However, the medical necessity must be proven. The BFH has clarified that a medical prescription may generally suffice if it shows that the liposuction was not for cosmetic reasons but was medically necessary due to lipoedema (BFH ruling of 10.08.2023, VI R 18/21).

Tip: Have the diagnosis and medical recommendation for liposuction confirmed in writing, preferably before the procedure.

Which costs can be considered?

Extraordinary expenses particularly include the treatment costs borne by the patient and necessary travel expenses. Reimbursements, for example from the health insurance company, must be deducted from the costs.

Important: Extraordinary expenses only have a tax effect if the eligible costs exceed the personal reasonable burden.

Liposuction performed exclusively for cosmetic reasons is still not deductible as an extraordinary expense.