FDA Adverse Event Injury Summary report: N

STYLE 15 SILICONE GEL FILLED BREAST IMPLANT

MDR report key: 23816556 · Received December 16, 2025

Report

Report Number
9617229-2025-21910
Event Type
Injury
Date Received
December 16, 2025
Date of Event
June 6, 2025
Report Date
February 26, 2026
Manufacturer
ALLERGAN (COSTA RICA)
Product Code
FTR
UDI-DI
10888628001503
PMA / PMN Number
P020056
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DEVICE EVALUATION: THE DEVICE RELATED TO THE REPORTED EVENTS RUPTURE WAS RECEIVED ON FEB 13, 2026 WITH LOT NUMBER 2183647. PER THE INVESTIGATION PROCEDURE, THE DEVICE IS ANALYZED THROUGH VISUAL INSPECTION MICROSCOPIC INSPECTION IF OPENINGS ARE OBSERVED AND A WEIGHT VERIFICATION. 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 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 (NON-PENETRATING NICKS) ARE FOUND TO BE POTENTIALLY RELATED TO THE MANUFACTURING PROCESS, AND, THEREFORE, NO FURTHER ACTIONS ARE REQUIRED FOR THESE OBSERVATIONS.

Additional Manufacturer Narrative · 0

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 · 0

ADDITIONAL, CHANGED, AND/OR CORRECTED DATA: B5, D6B, H6.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED RUPTURE. LATER, HEALTHCARE PROFESSIONAL REPORTED "BLOODY NIPPLE DISCHARGE". THIS RECORD IS FOR THE LEFT SIDE. DEVICE WAS EXPLANTED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED RUPTURE. THIS RECORD IS FOR THE LEFT SIDE. DEVICE REMAINS IMPLANTED.

Description of Event or Problem · 0

DEVICE HAS BEEN EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2281718 STYLE 15 SILICONE GEL FILLED BREAST IMPLANT PROSTHESIS, BREAST, NONINFLATABLE, INTERNAL, SILICONE GEL-FILLED FTR ALLERGAN (COSTA RICA) 2183647 10888628001503

Patients

Seq Age Sex Outcome Treatment
1 35 YR Female Required Intervention