Since silicone has rapidly become one of the most commonly used prosthetic materials in the last 30 years in modern medicine, we have consequently been witnessing more silicone-related disease. Especially after silicone breast implantation, defects in the breast implant have led to serious complications, whereas complications of silicone prosthesis implantation in other body parts are less frequent. Here we present an unusual clinical presentation of a silicone granuloma in a patient with a 27-year history of a wide excision of a melanoma of the right lower extremity and subsequent soft-tissue reconstruction using a silicone device.