TaxTMI 
TaxTMI 
2023 (8) TMI 615
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....ft Treatment, Hairloss therapy, Mesotheraphy, Dermaroller sitting, Ozone & Laser treatment, Platelet Rich Plasma(PRP), and Radio Frequency Treatment undertaken by the appellant are all taxable under cosmetic surgery and plastic surgery and not eligible for exemption under Notification 25/2012-ST dated 20.06.2012. However, he held that the extended period of limitation cannot be invoked in respect of all activities, other than Autologus Micrograft Treatment and Radio Frequency Treatment as these activities were in the knowledge of the Department owing to the audit of the appellant for the period 2009-10 to 2013-14. The demand on the remaining two services viz., Autologus Micrograft Treatment and Radio Frequency Treatment has been confirmed as these services were not provided earlier during the period of audit. The present appeal is only against the confirmation of demand on two services viz., Autologus Micrograft Treatment and Radio Frequency Treatment for the extended period along with imposition of equal penalty. 2. The brief facts are that the appellant is engaged in providing services relating to diagnosis, treatment and care for various hair and skin related diseases/illness, ....
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....e Notification. With regard to the Cosmetic & Plastic Surgery, learned counsel pointed out that CBEC (now CBIC), vide D.O.F. No. 334/13/2009- TRU dated 06.07.2009, had clarified that as per common definition, surgery is a medical technology consisting of physical intervention on tissues and that as a general rule a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. The impugned order also relies on the said CBEC Circular. 4. Learned counsel, therefore, contended that cosmetic or plastic surgery is excluded from the purview of the Notification. The submission is that to be excluded from the benefit of Notification, the treatment/procedure in question must be surgical in nature. From the procedure of treatment given in the impugned order, it is evident that it does not involve any cutting of patient's tissues or closure of a previously sustained wound. Therefore, in terms of the CBEC Circular dated 06.07.2009 (cited supra), it does not qualify to be considered as a surgical treatment and the finding of the learned Principal Commissioner in the impugned order holding it to be a type of surgery and consequent de....
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....he case of Livelife Hospitals Pvt. Ltd. Vs. CCT, Hyderabad 2023-TIOL-390-CESTAT-HYD. Therefore, the term 'cosmetic or plastic surgery' is required to be construed as referring to only that treatment which is surgical in nature, consequently, non-surgical treatment cannot be denied the benefit of exemption under the notification. He relied on the judgment of the Supreme Court in the case of Pappu Sweets and Biscuits Vs. Commissioner of Trade Tax, U.P., Lucknow [2004 (178) ELT 48 (SC)]. This judgment was followed by the CESTAT, New Delhi recently in the case of Commissioner of Customs (Air), Chennai-VII Vs. Ingram Micro India Pvt. Ltd. [2023 (383) ELT 455 (Tri.-Del.)]. 9. The learned Authorised Representative stated that Autologous Micrograft Treatment is used to treat Androgenetic Alopecia andTelogen Effluvium, which is male and female pattern baldness. Both genders share its causes, which are mainly genetic inheritance, hormonal imbalance etc. He stated that Hair follicles are complex structures that go through different biological stages from an active growth stage (anagen phase), to an intermediate remodelling stage (catagen phase),and then to a quiescent stage (telogen phase). ....
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....ion 3, Sub-section (i) vide number G.S.R. 210 (E), dated the 17th March, 2012, the Central Government, being satisfied that it is necessary in the public interest so to do, hereby exempts the following taxable services from the whole of the service tax leviable thereon under section 66B of the said Act, namely:- 1. Services provided to the United Nations or a specified international organization; 2.(i) Health care services by a clinical establishment, an authorised medical practitioner or para-medics; ............................................ 2. Definitions. - For the purpose of this notification, unless the context otherwise requires, - ..................................................................................................................... (j) "clinical establishment" means a hospital, nursing home, clinic, sanatorium or any other institution by, whatever name called, that offers services or facilities requiring diagnosis or treatment or care for illness, injury, deformity, abnormality or pregnancy in any recognised system of medicines in India, or a place established as an independent entity or a part of an establishment to carry out diagnostic o....
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....rgery is performed in a sterile environment with anesthesia and antiseptic conditions using surgical instruments. It also includes 'non-invasive' surgery. 2.4.2 Some of the commonly known aesthetic/cosmetic surgeries are abdominoplasty (tummy tuck); bletharoplasty (eyelid surgery); mammoplasty; buttock augmentation and lift; rhinoplasty (reshaping of nose); otoplasty (ear surgery); Rhytidectomy (face lift); liposuction (removal of fat from the body); brow lift; cheek augmentation; facial implants; lip augmentation; forehead lift; cosmetic dental surgery; orthodontics; aesthetic dentistry; laser skin surfacing etc. 2.4.3 However, any reconstructive surgery undertaken to restore one's appearance, anatomy or bodily functions affected due to congenital defects, developmental abnormalities, degenerative diseases, injury or trauma would be outside the scope of this service. These processes could be undertaken to correct impairment caused by burns, fractures or congenital abnormalities like cleft lip etc....." 12.2 A conjoint reading of the notification reveals that the exemption is for healthcare services provided by a clinical establishment and authorised medical practitioner or....
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....man Hair Growth: A Literature Review" by Arjavon T Talebzadeh and Nojan Talebzadeh has stated that "Medications such as some beta-blockers and antidepressant and chemotherapy could have secondary hair loss known as telogen effluvium as side effects. Illness such as hypothyroidism has also been associated with thinning hair, and certain dietary deficiency that may include zinc, iron, and biotin could also have same results. Autoimmune conditions such as alopecia areata (AA) have also been shown to lead to hair loss." What is clear from above is that the said treatment is not used to prevent or address any disease per se, rather it is to address the consequences of disease which can be Androgenetic Alopecia and/or Telogen effluvium. In this context we find that the Supreme Court in the case of Puma Ayurvedic Herbal (P) Ltd vs Commissioner of Central Excise [2006(196) ELT 3(SC)] in paragraph 20 has held as follows:- "20. It will be seen from the above definition of cosmetic that cosmetic products are meant to improve appearance of a person, that is the enhance beauty. Whereas a medicinal product or a medicament is meant to treat some medical condition. It may happen that while treat....
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......................" 13. From the above, it is apparent that the Autologous Micrograph Treatment undertaken by the appellant is to treat Androgenetic Alopecia and/or Telogen effluvium i.e. baldness which has been recognised to be an illness. Once Androgenetic Alopecia/Telogen Effluvium is recognised as illness, we hold that the same is covered by the definition of healthcare services given in 2(t) of the notification. Any improvement in appearance is not a consequence of such a treatment, as has been categorically held by the Supreme Court in Puma Ayurvedic Herbal (supra). It is pertinent to note that the Notification excludes Hair Transplant from its ambit, but in the instant case, there is no hair transplant as such. There is only injection of a stem cell -like rich solution into the thinning areas of the head. This does not involve any surgery or surgical procedure which involves cutting of a patient's tissues or closure of a previously sustained wound. Accordingly, we hold that the Autologous Micrograph Treatment is eligible for exemption under Notification 25/2012(supra). 14. We now address the second issue before us as to whether Radio Frequency Treatment is a cosmetic surg....