Nontobacco Nicotine Dependence Is Associated with Increased Postoperative Complications Following Breast Reconstruction.

Background: Nontobacco nicotine products serve as an alternative to traditional tobacco products, as people often view them as safer options. However, the effects of nontobacco nicotine products on breast reconstruction surgery have not been established. Our aim is to evaluate the association between preoperative nontobacco nicotine dependence (NTND) and the incidence of postoperative complications following breast reconstruction procedures. Methods: A retrospective cohort study was performed using the TriNetX Global Collaborative Network. Patients older than18 years who had breast reconstruction surgery were divided into 2 groups: those who had documented NTND within 1 year before surgery and those who had no documented nicotine dependence. Two subanalyses were conducted for autologous and implant-based reconstruction. Propensity score matching was applied to balance baseline variables. Primary outcomes were 30- and 90-day postoperative complications. Results: A total of 87,774 patients met inclusion criteria. After propensity score matching, our primary analysis included 2170 patients in each cohort. The NTND cohort had a significant increased risk of surgical site infection and wound dehiscence within 30 days. After 90 days, surgical site infection, wound dehiscence, and tissue-expander removal were significantly increased in the NTND cohort. Conclusions: NTND is associated with an increased risk of short-term complications regardless of the surgical technique.