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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) STYLE 468 SALINE FILLED BREAST IMPLANT; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE

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ALLERGAN (COSTA RICA) STYLE 468 SALINE FILLED BREAST IMPLANT; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE Back to Search Results
Catalog Number 468-350
Medical Device Problem Codes Fluid/Blood Leak (1250); No Apparent Adverse Event (3189)
Health Effect - Clinical Codes Failure of Implant (1924); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/15/2025
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "manual deflation and exchange from textured to smooth devices due to the patient's concern with the product".This record is for the right side.Device was explanted.Device will be returned.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances noted.Further information from the reporter regarding event, product, or patient details has been requested.No additional information is available at this time.Reason for reoperation: deflation.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected data: b2, b3, b5, d9, h3, h6.
 
Event or Problem Description
Healthcare professional reported right side "manual deflation" and exchange from textured to smooth devices due to the patient's concern with the product.Healthcare professional additionally reported right side "needle deflation".Upon review of the information by abbvie medical safety, it has been determined that the intentional deflation of the right side implant is not a complaint against the device.
 
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Brand Name
STYLE 468 SALINE FILLED BREAST IMPLANT
Common Device Name
PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE
Manufacturer (Section D)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS 
Manufacturer (Section G)
ALLERGAN (COSTA RICA)
900 parkway global park
zona franca
la aurora de heredia
CS  
Manufacturer Contact
terry ingram
2525 dupont drive
irvine, CA 92612
8479366324
MDR Report Key23335526
Report Number9617229-2025-17876
Device Sequence Number15914100
Product Code FWM
UDI-Device Identifier10888628001121
UDI-Public10888628001121
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
P990074
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2007
Device Explanted Year2025
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 11/14/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Expiration Date08/29/2007
Device Catalogue Number468-350
Device Lot Number613125
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 09/30/2025
Supplement Date Received by Manufacturer11/11/2025
Initial Report FDA Received Date10/20/2025
Supplement Report FDA Received Date11/14/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/02/2003
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Outcome Attributed to Adverse Event Required Intervention;
Patient Age56 YR
Patient SexFemale
Patient Weight54 KG
Patient EthnicityNon Hispanic
Patient RaceWhite
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