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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MENTOR TEXAS MENTOR SMOOTH ROUND MODERATE PLUS PROFILE; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE

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MENTOR TEXAS MENTOR SMOOTH ROUND MODERATE PLUS PROFILE; PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE Back to Search Results
Catalog Number 3502600
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code Deformity/ Disfigurement (2360)
Date of Event 01/27/2026
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that a patient underwent a primary breast augmentation surgery with implantation of a 600cc mentor smooth round moderate plus profile saline breast implant prosthesis.Post-operatively, the patient was diagnosed with a deflated right implant during a physical exam.As a result, the patient underwent right-sided exchange with a mentor saline implant on (b)(6) 2026.
 
Additional Manufacturer Narrative
Since the device has not been returned for analysis, no product failure analysis can be conducted, and no determination of possible contributing factors can be made.As such, the investigation will be closed.If the complaint device is received in the future, the investigation will be reopened and conducted as appropriate.A manufacturing record evaluation (mre) was performed, and no anomalies were found related to this complaint.In addition, the mre verifies that the device was manufactured in accordance with documented specification and procedures.Reason for device explant and/or reoperation: deflation.Mentor is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which mentor has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, mentor, or its employees that the report constitutes an admission that the device, mentor, or its employees caused or contributed to the potential event described in this report.If certain information is unknown, not available or does not apply, the section/field of the form is left blank.Manufacturer¿s reference number: (b)(4).
 
Additional Manufacturer Narrative
On february 23, 2026, mentor was provided with the patient ethnicity.Ethnicity: not hispanic/latino.Manufacturer¿s reference number: (b)(4).
 
Additional Manufacturer Narrative
On march 20, 2026, the mentor analysis lab received the suspect medical device for evaluation.On march 26, 2026, mentor completed an evaluation on the returned device.Device evaluation: mentor conducted a visual inspection and microscopic examination of the device.Visual analysis of the returned device revealed that the breast implant had a crease/fold on the posterior view.In addition, a tear was noted within the crease/fold measuring approximately 0.3 cm.A microscopic examination was performed and instrument damage was not found on the area of the tear.The evaluation determined that the possible cause of the rupture is consistent with normal wear.Deflation can occur at any time after implantation, but it is more likely to occur the longer the implant is implanted.Creating wrinkles or folds should be avoided during implantation or other procedures as it can result in a deflation in a later time.Breast implants may also simply wear out over time.Manufacturer¿s reference number: (b)(4).
 
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Brand Name
MENTOR SMOOTH ROUND MODERATE PLUS PROFILE
Common Device Name
PROSTHESIS, BREAST, INFLATABLE, INTERNAL, SALINE
Manufacturer (Section D)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer (Section G)
MENTOR TEXAS
3041 skyway circle north
irving TX 75038
Manufacturer Contact
henry boden
3041 skyway circle north
irving, TX 75038
9497882078
MDR Report Key24434249
Report Number1645337-2026-01963
Device Sequence Number10244303
Product Code FWM
UDI-Device Identifier00081317001492
UDI-Public(01)00081317001492(17)260927(10)9796849
Combination Product (Y/N)N
Initial Reporter StateTN
Initial Reporter CountryUS
PMA/510(K) Number
P990075
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2023
Device Explanted Year2026
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other
Type of Report Initial,Followup,Followup
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 Date09/27/2026
Device Catalogue Number3502600
Device Lot Number9796849
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/04/2026
Supplement Date Received by Manufacturer02/23/2026
03/20/2026
Initial Report FDA Received Date02/24/2026
Supplement Report FDA Received Date03/19/2026
03/30/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/28/2022
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 Age65 YR
Patient SexFemale
Patient EthnicityNon Hispanic
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