Background: Siliconosis was first described in the late 1980s and it is still remaining as a rare condition and mainly as a diagnosis of exclusion after breast cancer investigation. There are only limited cases reported and published with even smaller amount related to the breast implants (31 studies and 8 related to breast implants found in PubMed search in December 2019). Case presentation: Authors present the case of siliconosis secondary to bilateral cosmetic breast augmentation performed back in 1989. The patient was troubled with a myriad of complications and underwent an exchange of implants with Trilucent™ implants in 1997 and their subsequent removal in 1998. Later, they underwent bilateral mastopexy and is currently free of implants. Ever-since the first operation patient complained of pain, localized tenderness, swelling, axillary fullness, paraesthesia and partial paralysis in her upper limbs amongst other symptoms. Objective investigations including plain radiographs, USS, CT, MRI, nerve conduction studies, rheumatological screen yielded essentially negative results. Thoroughly investigation for breast cancer was conducted, including several operations and biopsies of axillary swellings with confirming reactive lymphadenopathy. A working diagnosis of siliconosis has been made and the patient was treated expectantly. Conclusion: This case should remind our colleagues of the ethical and professional responsibilities we have toward our patients in explaining all the potential risks involved in breast augmentation and also to keep an open mind when meeting patients complaining of systemic symptoms post breast augmentation.

Keywords: Syliconosis, autoimmune/inflammatory syndrome induced by adjuvants (ASIA), silicone implant incompatibility syndrome (SIIS), breast augmentation, breast implants