Breast augmentation with free silicone particle injection is a technique that was popular from the 1950s to the 1970s. It was used as an inexpensive alternative to surgical augmentation. Although no longer performed, patients who underwent silicone particle augmentation are occasionally encountered. Imaging of breast tissues in these patients is complicated as the presence of extensive silicone particles may hide the signs of early breast cancer. In addition the chronic presence of such particulate material may cause ongoing inflammation which can distort normal breast tissue architecture, mimicking breast cancer. The authors describe a patient who underwent free silicone injection for breast augmentation in the 1960s, and developed an incidental new mass on chest CT 40 years later.