“Without standards, there can be no improvement”—Taiichi Ohno

After introducing silicon filled breast implants over half a century ago in 1963 (1), studies concerning all aspects of heterologous breast augmentation have been conducted. These range from different aspects of why? how? and where? through to thorough investigations on social, psychological and physical complications, ranging from short to long term, as well as complication assessment and management and means of complication reduction. The introduction of different means of complication control, for example those evaluated by the Dutch Breast Implant Registry (DBIR) such as implant immersion in antiseptic solution or administration of intravenous antibiotic or the placement of drainages (2) have led to significant changes in surgical practices and thus furthered the evolution of breast implant surgery. Spronk et al. (2) have analysed the DBIR, first established in 2015 and have found high participation rates for hospitals and private clinics. The DBIR enabled a minimum estimate of implant incidence rate for Dutch women, an understanding for indication, as well as for patient, device and surgery characteristics. Furthermore different infection control measures were analysed. The results emphazise the benefit of further developments regarding national data base and ultimately breast implant surgery (2)