Calculating risk factors is inherently difficult when the real exposure is unknown1. This is particularly true of breast implant associated anaplastic large cell lymphoma (BIA-ALCL) whereby the true number of breast implants that make their way into human bodies is not known. As such, best estimates have been derived from sales data, rather than implant registries although with the advent of the latter, it is hoped that this will significantly improve, but of course this will be dependent on uptake in the use of registries by surgeons2. This recent publication from Australia describes data collection both retrospectively and prospectively (October 2015-May 2019) conducted to deduce the risk of BIA-ALCL with respect to the implant manufacturer, surface area and texture as well as the certification status of the practicing surgeon3. In addition, this work takes account of the number of implants received by each patient and accounts for the manufacturer of the last implant in place at the time of diagnosis. Notably, the last implant in every case (n=27 women with multiple implants) is of a textured variety with 52% being Allergan Biocell implants3.