Postoperative complications following mastopexy and reduction mammaplasty in patients with cannabis use disorder: a propensity-matched cohort study.

PURPOSE: Cannabis use disorder (CUD) is increasingly prevalent among surgical patients, yet its association with postoperative complications following breast surgery remains poorly characterized. This study compared rates of surgical site complications and emergency department (ED) utilization after mastopexy and reduction mammaplasty between patients with and without documented CUD.

METHODS

A retrospective, propensity-matched cohort study was performed using the TriNetX federated research network. Patients undergoing mastopexy or reduction mammaplasty with documented CUD within 3 years before surgery (cannabis cohort) were matched 1:1 to patients without CUD (control cohort) on age, sex, race, ethnicity, comorbidities, and procedure type. Patients with cocaine or methamphetamine use were excluded from both cohorts. Primary outcomes included 90-day rates of surgical site infection (SSI), wound dehiscence, and seroma or hematoma, as well as 30-day ED visits. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated.

RESULTS

Among 2444 matched patients (1222 per group), CUD was associated with higher rates of surgical site infection (3.8%vs 2.0%; RR, 1.84; P = 0.011), seroma or hematoma (3.6%vs 2.0%; RR, 1.83; P = 0.014), and 30-day ED visits (14.2%vs 9.6%; RR, 1.48; P < 0.001). Wound dehiscence rates did not differ significantly (5.6%vs 4.2%; RR, 1.35; P = 0.092). Causal attribution of outcomes to the index procedure could not be established.

CONCLUSIONS

CUD was associated with modestly increased rates of wound complications and ED utilization following mastopexy and reduction mammaplasty. While absolute risk differences were small, these findings may inform preoperative counseling and postoperative monitoring in this population.