SteuerGo FAQs

(2023) Are expenses for liposuction tax deductible?

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

Liposuction to treat lipoedema is a procedure where fat cells are removed from specific areas under the skin using cannulas. Lipoedema is a fat distribution disorder that mainly occurs in the thigh, buttock, and hip areas, as well as the inner knees and lower legs. This condition is better known as saddlebag phenomenon or column legs. The question is whether liposuction is always considered a cosmetic procedure (which is recognised for tax purposes) or whether it can also be a medically necessary treatment whose costs are tax-deductible.

The Finance Court of Baden-Württemberg did not recognise the costs for liposuction to treat lipoedema in 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, 4.2.2013, 10 K 542/12).

Currently, the Federal Fiscal 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 scientific recognition, an expert opinion should be obtained" (BFH ruling of 26.6.2014, 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 for a reliable assessment" (BFH ruling of 26.6.2014, VI R 51/13).

From the decision, it can be inferred that the BFH wishes to recognise the costs for the treatment 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, in similar cases, it is advisable to appeal against the negative tax assessment and refer to the BFH ruling.

Currently, the Saxon Finance Court has recognised the costs of liposuction for lipoedema as an extraordinary burden. These costs are tax-deductible if there is a medical prescription. A prior public health officer's certificate is no longer required, deviating from previous financial court rulings (Saxon FG, 10.9.2020, 3 K 1498/18, revision VI R 39/20).

The Federal Fiscal Court recently ruled that the costs for liposuction to treat lipoedema are tax-deductible. This applies from 2016 and generally does not require public health officer reports or medical certificates (BFH ruling of 23.3.2023, VI R 39/20).