Plastic surgery and hair transplants could be hit with a new tax – to help finance Barack Obama's planned reforms to the American healthcare system.

The idea comes from a top Obama aide who suggested the 10% 'Botax' on cosmetic surgery deemed unnecessary for medical purposes.

The current US healthcare system leaves 46 million without health insurance – but Congress is staggered by the cost of reform – an estimated $1trillion over ten years.

The so-called 'vanity tax' has been promoted as part of a solution and described as 'a progressive tax on the wealthy'. But opponents say it is sexist as women make up 90% of cosmetic surgery patients.

All told, Americans spent $10.3bn on cosmetic surgery last year, down 9% from 2007. It is not known how much the tax would raise.

However, a spokesman for the American Society of Plastic Surgeons, doubted the proposal would raise enough, even if it was introduced.

He said a similar tax in New Jersey only brought in about 25% of the funds lawmakers expected when they passed it in 2004.