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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 FF-410740
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code Failure of Implant (1924)
Date of Event 07/29/2025
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Further information from the reporter regarding event, product, or patient details has been requested.No additional information is available at this time.A review of the device history record has been completed.No deviations or non-conformances noted.Reason for reoperation: rupture.
 
Event or Problem Description
Healthcare professional reported "rupture" and "exchange of textured devices due to product concern".This record is for the right side.Device remains implanted.
 
Additional Manufacturer Narrative
Device evaluation: the device related to the reported events of rupture and anxiety-product/procedure was received on april 27, 2026, with lot number 2475691.Per the investigation procedure, the device is analyzed through visual inspection microscopic inspection if openings are observed and a weight verification.Per the analysis performed, the assessments of the complaints and any potential manufacturing issue are displayed along with any further actions required: ¿ rupture: observed broken device through microscopic inspection assessed as unidentified (tear) opening and missing piece of shell assessed as inconclusive.No further actions are required as it is not related to the manufacturing process.¿ anxiety-product/procedure: unable to observe through visual inspection as it is a physiological phenomenon.No additional observations performed on the device.No further actions are required.
 
Event or Problem Description
Healthcare professional reported "rupture" and "exchange of textured devices due to product concern".This record is for the right side.Device was explanted.
 
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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 Key24280259
Report Number9617229-2026-02488
Device Sequence Number18623694
Product Code FTR
UDI-Device Identifier10888628002739
UDI-Public10888628002739
Combination Product (Y/N)N
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
P040046
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2014
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 05/19/2026
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? Yes
Operator of Device Health Professional
Device Expiration Date05/14/2018
Device Catalogue NumberFF-410740
Device Lot Number2475691
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/20/2026
Supplement Date Received by Manufacturer04/21/2026
Initial Report FDA Received Date02/06/2026
Supplement Report FDA Received Date05/19/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/14/2013
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 Age67 YR
Patient SexFemale
Patient Weight88 KG
Patient EthnicityNon Hispanic
Patient RaceWhite
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