Free liquid silicone breast injections have been used for off-label breast augmentation since the 1960s. Shortly after the invention of this technique, multiple adverse effects became apparent and the technique became illegal in most countries. The procedure continues to be undertaken owing to its decreased cost compared with silicone prostheses. Complications from free silicone injections lead to complex management issues and health risks. This case demonstrates severe silicone migration, the extent of which has not previously been documented. In addition, the migration caused a serious life-threatening complication with subsequent complex management issues.