PhD defence B.E. (Babette) Becherer

The female breasts play an essential role in physical and mental well-being throughout different stages of a woman’s life. Since the early 1960s, breast implants have been routinely
used to (re)create the shape and look of a breast or to enlarge a breast. Although breast implants have been shown to increase women’s physical and mental well-being, they
are not without complications.(1-3) In addition to surgery-related and implant-related complications, manufacturing problems may negatively impact patient safety. Additionally,
before the start of the studies in this thesis, it was still unknown how many women carry a breast implant. Therefore, national breast implant registries play an important role.
In response to the Poly Implant Prothèses crisis in 2010, when breast implants appeared to be manufactured with non-medical-grade silicone, several countries developed a new
generation of independent, national breast implant registries.(4-14) To share best practices and facilitate international collaboration, these registries united in the International
Collaboration of Breast Registry Activities (ICOBRA).(5, 15) One of these new registries was the Dutch Breast Implant Registry (DBIR), initiated by the Netherlands Society of Plastic Surgery. DBIR is an opt-out registry that registers patient, implant, and surgery characteristics since April 2015. It captures implanted and explanted temporary tissue expanders and “permanent” breast implants. DBIR has three primary purposes: 1) to monitor and evaluate the quality of care using clinical auditing, 2) to monitor and evaluate the quality of inserted breast implants, and 3) to serve as a track-and-trace system in case of a recall. Registration in DBIR is mandatory for all board-certified plastic surgeons in the Netherlands, and a certified Trusted Third Party securely manages the data in compliance with the General Data Protection Regulation.

The studies in this thesis aimed to provide insight into breast implant surgery practice in the Netherlands (part I), to investigate nationwide variation in surgical practice and outcomes (part II), and to assess the potential of combining DBIR data with other registries on a national and international level (part III).

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 13.00 PM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.