Don't Mess With Taxes

Cosmetic surgery? Nope.

Corrective medical surgery that just happened to make a few facial improvements? You betcha!

As soon as celebrity watchers got a look at Bristol Palin's new-look face -- a more angled jaw and sharpened chin -- speculation began.

The 20-year-old reality television star wouldn't immediately confirm or deny that she had undergone plastic surgery.

But when the questions wouldn't stop -- hey, you willingly put yourself out there in the public arena, inquiring minds will demand to know -- the oldest daughter of former Alaska governor Sarah Palin clarified her facial work situation.

"I had corrective jaw surgery" back in December 2010, the new Bio channel reality star told Us Weekly in its edition on newsstands today. (That's the same publication that got the official coverage of Bristol's and Levi Johnston's quickly broken re-engagement last summer. Do I smell a Palin contract?)

"Yes, it improved the way I look, but this surgery was necessary for medical reasons…so my jaw and teeth could properly realign…I don't obsess over my face," Palin told the gossip magazine.

Better smile and tax deduction, too: I suspect that Bristol has some type of health insurance coverage, so her medically-necessary jaw work is probably covered.

The requirement that a doctor determine that plastic surgery is required for health reasons also applies to deducting medical costs on your tax return. Qualifying medical treatment bills can be counted as itemized deductions on Schedule A to the extent that they exceed 7.5 percent of your adjusted gross income.

The IRS word on cosmetic surgery, direct from Publication 502, Medical and Dental Expenses, is:

Generally, you cannot include in medical expenses the amount you pay for unnecessary cosmetic surgery. This includes any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. You generally cannot include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction.

You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.

Example: An individual undergoes surgery that removes a breast as part of treatment for cancer. She pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly related to the disease. The cost of the surgery is includible in her medical expenses.

I've also got to take a quick tax detour here. I find it just too, too funny that in IRS Pub. 502's alphabetic list of possible medical deductions, "dancing lessons" comes right after "cosmetic surgery." Could it be that Bristol, in checking out expenses for her 2010 Dancing With the Stars appearance, saw the prior entry and thought, "Hmmm."

But back to Bristol's new look.

She's "absolutely thrilled with the results" because it makes her "look older, more mature."

Ah, the perspective of a woman barely two decades old.

Years from now when looking older and more mature is not as appealing, Bristol can go under the plastic surgeon's knife again.

And she'll know that this return and purely vanity visit to the operating room will not be tax deductible.

Personal medical note: One year ago today I spent the morning at my local hospital's emergency room where I learned that I had indeed broken my left wrist. That's the X-ray of the plate the orthopedic surgeon put in six days later.

I had planned to post another medical/tax related item today to mark the anniversary, but then the Bristol Palin plastic surgery story showed up with its tax hook.

I guess that the blogging gods wanted to make sure I did commemorate this day with some sort of medical post.

Related posts:

• 10 million itemized medical deductions
• Maximize your medical deductions
• Bunching medical expenses
• Tax note to Charlie Sheen: rehab costs
  are a deductible medical expense
• Breaks of my wrist, and for medical costs
• Breast pumps are tax deductible and allowable FSA expenses

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