A number of states are considering taxing certain cosmetic surgery procedures, including laser hair removal, face-lifts, and Botox® injections. Plastic surgeons and their patients have been lobbying hard to prevent these 'vanity taxes' or 'Botaxes', as some call them. States legislators consider the taxes as plastic surgery continues to grow in popularity. Nationally, there were 9.2 million cosmetic plastic surgery procedures performed last year, a 24% jump from 2000, according to the American Society of Plastic Surgeons. Americans spent $8.4 billion on cosmetic surgery last year.

New Jersey passed the first cosmetic surgery tax law last summer, slapping a 6% tax on cosmetic procedures like chemical peels, injectibles, and liposuction. Since then, lawmakers in states including Texas, Illinois, Washington, Arkansas, Tennessee and New York have introduced bills or budget proposals to install similar taxes, although none of those states has passed the taxes into law. Proponents of the efforts say that since the taxes are levied on elective procedures, they are relatively painless ways to raise money for state programs.

The health-insurance industry and the federal government already treat plastic surgery differently than other medical procedures. In general, health-insurance plans don't cover most elective cosmetic surgery, unless related to a disease, birth defect or accident. Also, patients generally can't include the cost of elective cosmetic surgery as a medical expense deduction on their federal tax returns. The cosmetic-surgery taxes are part of a growing effort by states to tax all sorts of other discretionary services, including massage. Ten states taxed massages as of last July, according to the Federation of Tax Administrators, which tracks state taxes.