Liposuction: HSA Eligibility

What is liposuction?

Liposuction, also known as lipoplasty and body contouring, is a cosmetic procedure that utilizes suction to remove fat from trouble areas of the body, including the abdomen, thighs, hips, buttocks, arms and neck. In addition to removing excess fat from these areas, surgeons who specialize in liposuction can also contour these areas. In most cases, liposuction is done when diet and exercise do not produce the desired results, but it is typically not an option for those with restricted blood flow, a weak immune system, diabetes or coronary heart disease that could complicate the recovery from the surgery (Medical News Today).

How is liposuction done?

A liposuction procedure will vary greatly on the type of procedure and part of the body that will be treated, but most patients' procedures will take the form of the following liposuction surgery techniques via The American Board of Cosmetic Surgery:

• Tumescent liposuction: This is the most common form of liposuction that utilizes a mixture of salt water, anesthetics and epinephrine that causes the affected area to swell and stiffen. Then, the surgeon will feed a thin tube called a cannula under the skin that suctions fat and fluids from the body.
• Ultrasound-assisted liposuction (UAL): While this technique is sometimes used in tandem with tumescent liposuction, it can also be done as a stand-alone procedure. UAL is conducted by inserting a metal rod under the skin that emits ultrasonic energy which can rupture fat cell walls and liquefy fat to make it easier to remove.
• Laser-assisted liposuction (LAL): This technique is similar to UAL, but utilizes high-intensity laser light to liquefy fat for easier removal. LAL is conducted by making a small incision along the affected area where a laser fiber is inserted and material is extracted with suction.
• Powered liposuction: Last but not least, powered liposuction is the preferred method on smaller areas like the arms, knees and ankles and utilizes a cannula in a rapid back-and-forth motion. Powered liposuction is usually less painful, causes less swelling and has a shorter recovery time than other techniques.

Why isn't liposuction eligible for reimbursement?

Under IRC 213(d)(1), "medical care includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body." This includes medical equipment, supplies and devices." Liposuction is a cosmetic procedure, and does not directly related to the diagnosis, cure, mitigation, treatment or prevention of a legitimate medical condition, and therefore would not be eligible for reimbursement with consumer-directed healthcare accounts like FSAs, HSAs, HRAs, DCFSAs or LPFSAs.