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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) STYLE 410 COHESIVE SILICONE GEL FILLED BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED

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ALLERGAN (COSTA RICA) STYLE 410 COHESIVE SILICONE GEL FILLED BREAST IMPLANT; PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED Back to Search Results
Catalog Number FX-410560
Medical Device Problem Code Malposition of Device (2616)
Health Effect - Clinical Code Appropriate Clinical Signs, Symptoms and Conditions Term/Code Not Available (4581)
Date of Event 10/29/2025
Type of Reportable Event Serious Injury
Event or Problem Description
The device has been explanted.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected data: b5, d6b, d9, h3, h6.
 
Additional Manufacturer Narrative
Device evaluation: per the analysis performed, the assessments of the complaints and any potential manufacturing issue are displayed along with any further actions required: ¿ crease / folding of implant: observed creases on device through visual inspection.No further actions are required as it is not related to the manufacturing process.¿ malposition: unable to observe through visual inspection as it is a physiological phenomenon.¿ visibility/palpability: unable to observe through visual inspection as it is a physiological phenomenon.None of the other observations performed during the device analysis (deformation, creases, wear abrasion and voids) are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.
 
Event or Problem Description
Healthcare professional reported "tissues are so thin" as no device related, "implant sitting lower on the chest wall", "exchange to smooth implants" and "few folds".This record is for the right side.The device was explanted.Patient have a thyroid disorder, high cholesterol and had a shoulder surgery.
 
Additional Manufacturer Narrative
Clarification h6: e2402 is to capture "right implant does sit lower on the chest wall".A review of the device history record has been completed.No deviations or non-conformances noted.The event of malposition is a physiological complication and analysis of the device generally does not assist allergan in determining a probable cause for this event.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: malposition.
 
Event or Problem Description
Healthcare professional reported "tissues are so thin" as not device related, "implant sitting lower on the chest wall", "exchange to smooth implants" and "few folds".This record is for the right side.The device remains implanted.
 
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Brand Name
STYLE 410 COHESIVE SILICONE GEL FILLED BREAST IMPLANT
Common Device Name
PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED
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 Key23590051
Report Number9617229-2025-19998
Device Sequence Number18609001
Product Code FTR
UDI-Device Identifier10888628003019
UDI-Public10888628003019
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
P040046
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2007
Device Explanted Year2025
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/05/2026
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? No
Operator of Device Health Professional
Device Expiration Date10/28/2011
Device Catalogue NumberFX-410560
Device Lot Number1367560
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 10/30/2025
Supplement Date Received by Manufacturer01/08/2026
01/26/2026
Initial Report FDA Received Date11/18/2025
Supplement Report FDA Received Date01/22/2026
02/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/30/2006
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 Age60 YR
Patient SexFemale
Patient Weight58 KG
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