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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 FM-410235
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code Failure of Implant (1924)
Date of Event 12/31/2025
Type of Reportable Event Serious Injury
Event or Problem Description
Device has been explanted and replaced.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected data: b5, d6b, h6.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformance's 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: rupture.
 
Event or Problem Description
Healthcare professional reported of the right side device: "rupture" and exchange from textured to smooth implants due to concerns with the product.The device remains implanted.
 
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: ¿ rupture: observed broken device through microscopic inspection assessed as assessed as fold flaw opening and observed a missing piece of shell through microscopic inspection assessed as inconclusive.No further actions are required as it is not related to the manufacturing process.None of the other observations performed during the device analysis (wear abrasion, delamination in the orientation dot and crease) 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 of the right side device: "rupture" and exchange from textured to smooth implants due to concerns with the product.Healthcare professional later reported "hole, non-specific".The 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 Key24382177
Report Number9617229-2026-03245
Device Sequence Number16004459
Product Code FTR
UDI-Device Identifier10888628002821
UDI-Public10888628002821
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
P040046
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2009
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup,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 Date12/19/2011
Device Catalogue NumberFM-410235
Device Lot Number1383779
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 02/03/2026
Supplement Date Received by Manufacturer03/06/2026
04/21/2026
Initial Report FDA Received Date02/18/2026
Supplement Report FDA Received Date03/15/2026
05/19/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/22/2007
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 Age59 YR
Patient SexFemale
Patient Weight63 KG
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