Background: Nicotine dependence is known to cause impaired wound healing and increase risk of surgical complications; nonetheless, the literature lacks evidence regarding the risks of capsular contracture and other implant-related complications. Methods: A retrospective cohort study was conducted using data from the TriNetX global health research network. Patients undergoing breast reconstruction were categorized into 2 cohorts: those with nicotine dependence documented within 6 months before surgery and those without nicotine use. Results: Propensity score matching was performed, resulting in balanced cohorts of 28,496 patients each. The nicotine dependence cohort had a higher incidence of seroma formation (risk ratio RR = 1.224 1.177–1.274; P 0.05) between the 2 cohorts regarding postmastectomy lymphedema syndrome and flap loss or failure. Conclusions: Nicotine dependence increases the risk of many surgical complications in breast reconstruction, consistent with previous studies. Interestingly, it also increases the risk of capsular contracture and other implant-related mechanical complications (malposition/displacement, rupture). These results emphasize the need for smoking and nicotine cessation before breast reconstruction.
Tanas et al. (Fri,) studied this question.