Cannabis use linked to higher surgical risks in breast reduction

The legalization and social acceptance of marijuana in the United States has led to a significant increase in its use. However, there is a paucity of data surrounding the effect of marijuana on surgical outcomes, posing challenges for risk stratification and perioperative management in plastic surgery. This study aimed to evaluate the relationship between marijuana consumption and postoperative outcomes in patients undergoing reduction mammaplasty (RM). A multicenter retrospective analysis was conducted to compare the outcomes in patients who underwent RM between 2019 and 2024. Patients were stratified based on marijuana use. The primary outcomes included postoperative complications. Multivariate logistic regression models were used to identify complications independently associated with marijuana use. A total of 1243 RMs were analyzed. Marijuana users accounted for 20.2% of the procedures (n = 251 RMs). Marijuana users were younger (28.6 years; interquartile range [IQR], 13.5 vs. 38.3 years [IQR, 22.5]; p < 0.001) and had higher rates of tobacco use (16.3% vs. 10.3%; p = 0.010). However, marijuana use was independently associated with increased risk of hematoma formation (3.2% vs. 1.0%; p = 0.010; odds ratio [OR], 2.972; p = 0.039) and delayed wound healing (12.8% vs. 8.3%; p = 0.028; OR, 1.946; p = 0.018). Perioperative marijuana use is associated with an increased risk of hematoma formation and delayed wound healing in RM patients. These findings underscore the need for standardized perioperative screening and counseling protocols regarding marijuana use.