PURPOSE: The impact of tetrahydrocannabinol (THC) use on plastic surgery patients has not been sufficiently explored. There is concern that patients who use THC have higher postoperative analgesic needs and complication rates. This study explored the demographics, complications, and postoperative analgesic needs of THC-using patients who have undergone breast reduction.
METHODS: A retrospective cohort study was carried out on patients who underwent breast reduction at Mount Sinai Health System between 2019 and 2023. THC usage, demographics, postoperative analgesia requirements, and postoperative complications were collected. Opioid-based analgesia was converted to oral morphine equivalents (OMEs). Patients with a recent history of THC use (<1 month) were compared to patients who have never used THC.
RESULTS: 262 patients were included in the study: 87 in the THC-using group (33.2%) and 175 in the non-THC-using group (66.7%). The mean age of patients in the THC-using group was significantly younger (p<0.001), and significantly more patients in the non-THC-using group had hypertension (p=0.018). There was no significant difference in total opioid doses in the immediate postoperative period (p=0.945), or when converted to OMEs (p=0.825). There was a significantly greater hematoma rate in the THC-using group (p=0.036).
CONCLUSION: Although there may be a concern that preoperative THC use may lead to increased postoperative analgesic requirements and complications, this study suggests otherwise, and THC use may not be a contraindication to breast reduction.