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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ALLERGAN (COSTA RICA) Inspira Textured Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled

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ALLERGAN (COSTA RICA) Inspira Textured Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled Back to Search Results
Catalog Number N-TSF295
Medical Device Problem Codes Device Appears to Trigger Rejection (1524); Material Rupture (1546)
Health Effect - Clinical Codes Capsular Contracture (1761); Seroma (2069)
Date of Event 01/01/2025
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "ruptured and encapsulated", capsular contracture baker grade iv, "periprosthetic effusion", "significant increase in volume which increases every day", "tense seroma", "destroyed", "disruption of the prosthetic capsule", "foreign body type giant cell granuloma against silicone and xanthomatous inflammation".This record is for the right side.The device was explanted.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances noted.The reported events of seroma-late and capsular contracture are physiological complications and analysis of the device generally does not assist allergan in determining a probable cause for these events.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, seroma-late and capsular contracture, baker grade iv.
 
Event or Problem Description
Healthcare professional reported "ruptured and encapsulated", capsular contracture baker grade iv, "periprosthetic effusion", "significant increase in volume which increases every day", "tense seroma", "destroyed", "disruption of the prosthetic capsule", "foreign body type giant cell granuloma against silicone and xanthomatous inflammation".This record is for the right side.The device was explanted.
 
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 an opening through microscopic inspection assessed as fold flaw opening.No further actions are required as it is not related to the manufacturing process.Capsular contracture: unable to observe through visual inspection as it is a physiological phenomenon.Seroma-late: unable to observe through visual inspection as it is a physiological phenomenon.None of the other observations performed during the device analysis (creases, non penetrating nicks and wear abrasion) are found to be potentially related to the manufacturing process, and, therefore, no further actions are required for these observations.Additional, changed, and/or corrected data: a5, a6, d4, d9, h3, h6.
 
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Brand Name
Inspira Textured 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
+1(847)936-6324
MDR Report Key25522469
Report Number9617229-2026-11412
Device Sequence Number21373693
Product Code FTR
UDI-Device Identifier10888628034105
UDI-Public(01)10888628034105(17)200317
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P020056
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2015
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 08/17/2026
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 Date03/17/2020
Device Catalogue NumberN-TSF295
Device Lot Number2716129
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/08/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/19/2026
Supplement Date Received by Manufacturer07/24/2026
Initial Report FDA Received Date06/16/2026
Supplement Report FDA Received Date08/17/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/17/2015
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 Age43 YR
Patient SexFemale
Patient Weight129 LB
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