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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Allergan (Costa Rica) Style 15 Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled

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Allergan (Costa Rica) Style 15 Silicone Gel Filled Breast Implant; prosthesis, breast, noninflatable, internal, silicone gel-filled Back to Search Results
Catalog Number 15-533
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/06/2026
Type of Reportable Event Serious Injury
Event or Problem Description
Patient reported "fluid, breast pain and denser" and "become sick and went to urgent care on (b)(6) 2026 were prescribed antibiotics".Later, patient reported "rupture".This record is for the right side.The device remains implanted.Patient received antibiotics as treatment.
 
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, edema, breast pain.
 
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Brand Name
Style 15 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 Key50874127
Report Number9617229-2026-18108
Device Sequence Number10716196
Product Code FTR
UDI-Device Identifier10888628001527
UDI-Public(01)10888628001527(17)150911
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
P020056
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2011
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/23/2026
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 Date09/11/2015
Device Catalogue Number15-533
Device Lot Number2028994
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 09/11/2026
Initial Report FDA Received Date09/23/2026
Date Device Manufactured10/11/2010
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 Other;
Patient Age46 YR
Patient SexFemale
Patient Weight164 LB
Patient RaceWhite
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