The Effects of Cannabis Use in Body Contouring Patients: A Retrospective Cohort Study

Goals/Purpose: Growing public support and increasing legalization efforts have resulted in increased cannabis use in the United States. Contrary to this, there is a paucity of information regarding the perioperative effects of cannabis in body contouring patients. In this study, we explored possible postoperative outcomes associated with a history of cannabis use in the setting of body contouring aesthetic surgery.

Methods/Technique: A commercially available database of 91 million unique patients, PearlDiver, was queried to identify patients between 2010 and 2020 who underwent common body contouring procedures and combinations of such procedures using Common Procedural Terminology (CPT) codes. Patients with a history of cannabis use disorder were matched 1:3 with patients without such history. Common postoperative complications were compared. A similar subanalysis was conducted comparing postoperative outcomes in the setting of cannabis use and tobacco use. Finally, a logistic regression, assuming binomial distribution, was performed to determine comorbidities and specific procedures associated with delayed wound healing after aesthetic body contouring surgery among all patients.

Results/Complications: A total of 150,415 patients underwent at least one body contouring surgery, and 1,375 (0.91%) had a prior history of cannabis use disorder. After matching for age, gender, and multiple comorbidities, 1,198 patients with cannabis use and 3,543 control patients were compared. Matched comparison demonstrated no significant differences in 90-day postoperative rates of surgical site infections (6.09% vs. 5.22%) or hematomas (4.84% vs. 4.32%). Cannabis users did have a significantly higher rate of delayed wound healing (8.68% vs. 4.91%, p < 0.001). Matched comparison of cannabis use and tobacco use demonstrated no differences in 90-day postoperative rates of surgical infection (3.69% vs 4.65%), hematomas (3.36% vs 3.18%), or delayed wound healing (5.37% vs 5.22%). Logistic regression demonstrated that cannabis use increased the likelihood of delayed wound healing (OR = 2.10, 95% CI = 1.73 - 2.52). Panniculectomy (OR = 2.34, 95% CI = 2.09 - 2.62) and thighplasty (OR = 3.37, 95% CI = 2.84 - 3.99) were among the procedures with the highest likelihood of delayed wound healing.

Conclusion: As marijuana use becomes more prevalent in the general population, it is imperative that plastic surgeons remain informed regarding its potential therapeutic and nontherapeutic effects in the perioperative setting. Inquiry regarding use can potentially guide preoperative counseling and prepare the surgeons and patients about any potential postoperative care needs following body contouring procedures.