PhD defence Jeanne Juliët Vrolijk

Keywords: Breast implants, Implant registry, Revision surgery, Patient safety

"Shaping Outcomes in Breast Implant Surgery"

Although breast implants have been used for decades to improve quality of life, concerns about their safety remain. This thesis evaluated breast implant performance and explored how registry data can improve breast implant surgery and patient safety. Using data from the Dutch Breast Implant Registry (DBIR), the first part examined whether implant characteristics influence complication and revision rates. A newly developed Digital Implant Catalog improved the accuracy of implant registration, and revision risk appeared to depend more on patient- and surgery-related characteristics than on implants themselves. Collaboration with an Australian registry showed among 150.000 implants that combining international data is feasible. The second part showed how registry data can drive current practice toward best practice: the COVID-19 pandemic disproportionately affected hospital-based breast cancer reconstructions, certain factors were found to increase the risk of needing an extra operation during reconstruction, and outcomes varied significantly between hospitals. Together, these findings give patients, surgeons, and policymakers tools to monitor implant safety, reduce avoidable complications, and improve breast implant care.

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