Impact of non-tobacco nicotine use on postoperative complications in breast reduction: A propensity score-matched analysis.

[BACKGROUND] Macromastia negatively affects the quality of life and has led to increased demand for breast reduction surgery. With the growing use of non-tobacco nicotine products, such as vapes, concerns have emerged about their potential impact on postoperative outcomes. This study aims to investigate whether non-tobacco nicotine dependence (NTND) is associated with an increased risk of postoperative complications following breast reduction.

[METHODS] The TriNetX database was queried to identify patients who underwent breast reduction. Patients were classified into 2 cohorts based on the diagnosis of NTND, excluding those with tobacco use or dependence. A propensity score-matching analysis was performed to adjust for risk factors associated with postoperative complications. The primary outcome was wound dehiscence, while secondary outcomes included surgical site infection, hematoma, seroma, opioid use, and emergency department visits. All outcomes were assessed at 30, 60, and 90 days following surgery.

[RESULTS] After matching, each group contained 2327 individuals. Patients with NTND had a significantly increased risk of wound dehiscence (risk ratio [RR] 1.97, p = 0.001), opioid use (RR 1.35, p < 0.001), and emergency department visits (RR 1.39, p = 0.006) at 30 days after breast reduction, compared to patients without NTND. Similar increases in risk were observed at 60 and 90 days after surgery. No significant differences were observed between the groups for surgical site infection, hematoma, or seroma at any time point.

[CONCLUSION] In this study, NTND is associated with an increased risk of wound dehiscence, emergency department visits, and opioid use following breast reduction surgery.