Don't deduct plastic surgery, but ...
If you simply are following your inner Joan Rivers, the IRS definitely won't let you deduct the costs of your nips and tucks.
The IRS specifically says you generally cannot include in deductible medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis) and liposuction.
But if a surgery is medically prescribed, for instance, a nose job to treat respiratory issues, and you just happen to like the look of your new sniffer, then that's OK. The doctor's decision makes it a medical deduction.
The IRS says: "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."
Remember, all your medical expenses, including any allowable plastic surgeries, must come to more than 7.5 percent of your adjusted gross income on your 2012 Schedule A before you can claim them. For the 2013 tax year, the medical deduction threshold is 10 percent of your AGI.