Recently the press reported that costs for plastic surgery for patients in the United Kingdom are to rise 20% due to a value added tax (VAT). This tax is to apply to all surgeries where a physician is not fixing function but form. One example would be breast reconstruction following a mastectomy versus breast augmentation surgery for enlargement. Plastic surgeons in the UK who perform primarily plastic surgery are required to register for this 20% tax, which they may pass on to patients. Thought he purpose of this VAT is to raise revenues during this time of economic hardship, British plastic surgeons urge that there is a fine balance between public finance and the well-being of patients. One plastic surgeon challenged Her Royal Majesty by asking whether otoplasty to fix a child’s prominent ears so he/she can fit in and avoid bullying should be subject to the VAT. While the UK has a national healthcare system, perhaps citizens in the US should be glad that this is not the case as government taxation can harshly impact a patient’s choice for what some officials categorize as frivolous. What may be frivolous to a government bureaucrat may be life changing and extremely helpful to the patient’s self image and self-esteem.