Nip and tuck tax has a few wrinkles

Beware: A tummy tuck tariff is lurking in the minds of Democrats.

They say vanity is a pricey pursuit and the state deserves a cut of the action.

Democratic state Sen. Karen Keiser proposed this week to charge a sales tax on cosmetic surgeries and spend the money on health care for low-income children.

She figures those who get the work done can afford to hand over a little extra for kids in need of routine checkups.

Maybe it will spur “Botox parties for babies,” she joked.

The idea is serious. Keiser’s co-sponsors are among those who will write the Senate’s version of the state budget and are seeking sources of revenue to fund the Democratic agenda.

As you might imagine, Republicans and surgeons want to nip the liposuction levy before it gets tucked into the final spending guide.

“It sounds like a tax on the ugly. She’s discriminating against the homely and the vain,” said Republican Sen. Pam Roach of Auburn, who is of a mind to arrange a Botox Tea Party.

Cosmetic surgery is a huge money-making industry, and only one state, New Jersey, taxes it. Nationwide, surgeons performed an estimated 8.7 million procedures in 2003 and earned $8.4 billion, according to the American Society of Plastic Surgeons.

Rhinoplasty, better known as a nose job, generated $1.14 billion alone. Close behind were Botox injections at $1.01 billion.

The average surgeon’s fee nationwide for a nose reshaping was $3,188, for a breast implant $3,375 and for a tummy tuck $4,641. Botox was cheap by comparison, at $376 a jab.

Keiser, citing New Jersey’s take, guessed that Washington could net $26 million a year from the tax. That would require $400 million worth of edifying, beautifying and satisfying surgeries.

By my calculations, one out of five adults in our state would have to buy a Botox injection each year to hit the bar. Or, 86,188 individuals would need to get a tummy tuck.

The tax would be paid by those older than 18 who seek cosmetic medical services or undergo cosmetic surgery that reshapes “the normal structures on the body to improve the body image, self-esteem or appearance.”

Reconstructive and medically necessary operations would not be taxed. Penile implants, an elective surgery, also would be exempt.

When New Jersey lawmakers enacted their vanity tax in June, they acted so swiftly in the final hours of the legislative session that doctors had no time to mount opposition.

There won’t be such an anesthetic response in Olympia Wednesday when the tax is debated in the Senate Health and Long-Term Care Committee.

Dr. Phil Haeck, a leader of the American Society of Plastic Surgeons, plans to tell legislators that as tempting as the tax seems, they must resist.

“This is not about vanity. This is about self-esteem,” he said. “How can you tax that?”

Reporter Jerry Cornfield can be reached at 360-352-8623 or

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