BACKGROUND: The Allergan Style 410 implant is a textured, anatomic, highly cohesive silicone gel-filled breast implant. Despite its widespread use in both Europe and Canada, limited data exist regarding long-term outcomes. The purpose of this study was to investigate outcomes using the Style 410 implant for primary subglandular breast augmentation. METHODS: A retrospective chart review was performed to identify all patients who underwent primary subglandular breast augmentation through an inframammary incision with the Style 410 implant. Patient demographics and implant characteristics were documented. Complications were examined, along with reoperation rate. RESULTS: Between 2002 and 2011, 440 consecutive patients were identified, with 16.6 percent of patients experiencing a complication and 10.7 percent requiring reoperation. The most common complication was malrotation, experienced by 5.2 percent of patients; this was largely managed nonoperatively. Baker grade III or IV capsular contracture occurred in 1.8 percent of patients, and 1.4 percent of patients presented with late seroma. No cases of anaplastic large cell lymphoma were identified. The most frequent indication for reoperation was revision breast surgery for inadequate cosmetic result (3.6 percent of patients). Larger implant volume correlated with significantly higher complication rates; however, implant profile did not. CONCLUSIONS: The complication and reoperation rates with the Style 410 implant are consistent with those of other implants. This device may possess certain inherent advantages over other breast implants currently available; however, there are also several problems associated with textured anatomic implants that must be considered when deciding on the best approach to breast augmentation for a patient. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.