Silicone injection and insertion (cosmetic)

Last revised by Qutaiba Jaf'ar Mahmoud on 28 Sep 2023

Silicone injection into various parts of the body has been used in many countries to achieve what are perceived to be cosmetic improvements. Most common sites for such injections are the breasts, face, and buttocks, although anywhere can be targeted. 

This article is a general discussion of the topic. For breast injection specifically, please refer to free silicone breast injection article. 

In most instances these injections are encountered incidentally when the body is imaged for other reasons. Complications from injection may, however, lead to local symptoms and require imaging. These include silicone granulomas (siliconoma), infection, fibrosis, and lymph node enlargement 1,2

Silicone granulomas can develop weeks to decades after injection and is particularly seen with illicit injection of non-medical grade silicone 1. Even with medical grade-silicone, granuloma formation is encountered in approximately 20% of individuals 1.

On mammography, free silicone injection appears as multiple dense nodules 1,2. These can also develop peripheral calcification 2

On CT, silicone injections and silicone granulomas appear as soft-tissue densities with surrounding fat stranding 1. Peripheral calcification may be present 2

On MRI, silicone injections have the following signal intensities 1

  • T1: low signal intensity (similar to water)
  • T2: high signal intensity (similar to or somewhat lower than water)
  • IP/OP: chemical shift artifact may be seen 1

Direct injection of liquid silicone was first used for cosmesis in the 1950s, becoming rapidly very popular, before finally being banned in the USA by the FDA in 1992 3. Despite this, it continues to be used extensively, both legally and illegally in some countries.

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