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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Allergan (Costa Rica) Style 45 Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled

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Allergan (Costa Rica) Style 45 Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled Back to Search Results
Catalog Number 45-600
Medical Device Problem Codes Device Appears to Trigger Rejection (1524); Material Rupture (1546)
Health Effect - Clinical Codes Capsular Contracture (1761); No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Serious Injury
Event or Problem Description
Healthcare professional reported "rupture" and "textured devices".This record is for left side.The device remains implanted.
 
Event or Problem Description
Healthcare professional reported "rupture" and "textured devices".Later healthcare professional reported capsular contracture baker grade iii and "hole in radius (edge)".This record is for left side.The device was explanted.Capsulectomy was performed.
 
Additional Manufacturer Narrative
A review of the device history record has been completed.No deviations or non-conformances 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.
 
Additional Manufacturer Narrative
Additional, changed, and/or corrected data: b2, b5, b6, b7, d6b, h.6, h11.The event of capsular contracture is a physiological complication and analysis of the device generally does not assist allergan in determining a probable cause for this event.
 
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Brand Name
Style 45 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)
Arklow
900 parkway global park zona f
zona franca
la aurora de heredia
CS  
Manufacturer Contact
terry ingram
2525 dupont drive
irvine, CA 92612
+1(847)936-6324
MDR Report Key50613640
Report Number9617229-2026-16892
Device Sequence Number10634504
Product Code FTR
UDI-Device Identifier10888628002111
UDI-Public(01)10888628002111(17)100328
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
P020056
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2008
Device Explanted Year2026
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/29/2026
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 Date03/28/2010
Device Catalogue Number45-600
Device Lot Number403626
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Received by Manufacturer Not provided
Supplement Date Received by Manufacturer09/14/2026
Initial Report FDA Received Date09/04/2026
Supplement Report FDA Received Date09/29/2026
Date Device Manufactured04/29/2005
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; Other;
Patient SexFemale
Patient Weight180 LB
Patient RaceWhite
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