Healthy skin centre

VAT on plastic surgery 'grotesquely unfair'

17th October 2011 - Plastic surgeons are warning that government plans to review VAT rules on 'cosmetic' procedures could add an extra 20% to the bills of patients undergoing surgery, even when operations are medically desirable.

The British Association of Aesthetic Plastic Surgeons (BAAPS) says it agrees that non-surgical 'cosmetic' treatments, such as botox and lasers, which make up nine out of 10 'cosmetic procedures', should attract VAT. However, it warns that bundling surgery, like breast reductions, tummy tucks and children’s bat-ear ops into the same category will produce an "ethical minefield".

A spokeswoman for HM Revenue and Customs (HMRC) tells us they are "constantly reviewing our guidance in consultation with the relevant trade bodies", but adds that there are no plans to change the VAT liability of cosmetic services.

Current guidelines from HMRC say that procedures are VAT exempt when "protection, maintenance or restoration" of health are the primary purpose. Procedures that are done for pure cosmetic reasons, though, attract the standard VAT rate.

Function or vanity?

Douglas McGeorge, consultant plastic surgeon and former BAAPS president says many cosmetic procedures and plastic surgery techniques inhabit a grey area between what is aesthetically desirable and what is purely functional. "How do I as a surgeon justify any functional element?" he asks.

He tells BootsWebMD: "The image of aesthetic surgery is the film star and the rich and famous pampering themselves. The reality is a long, long way from that. It's something that a large section of the community do."

Mr McGeorge gives examples of an older person being unhappy at work and overlooked for promotion because they have developed a hang-dog look on their face; a woman might have developed back pain because childbirth had damaged her abdominal wall.

He questions whether it is possible to draw a clear line between aesthetic and functional benefits. "Should children having their teeth straightened pay VAT? There is no functional element in straightening teeth - it's essentially to give them a nice smile," he says.

Clarifying the rules

In an emailed statement, HMRC says "There have been no changes to, nor are there any plans to change, the VAT liability of cosmetic services. Medical care provided by registered health professionals in hospitals or clinics is and will continue to be VAT free, along with cosmetic services carried out for therapeutic purposes.

"Medical treatment for purely aesthetic reasons has been, and continues to be, liable to VAT at the standard rate.”