The restoration and improvement of body contour have intrigued surgeons for over 100 years, generating much interest in the subcutaneous/intradermal injection of highly viscous fluids. The local complications of liquid silicone injection have been well documented over the past 30 years. Although Dow-Corning has not made medical-grade liquid silicone available for use in humans without an approved research application since 1966, practitioners, both licensed and unlicensed, have administered these injections worldwide for a variety of indications throughout the body. There is little or no information concerning the adulteration of these injectates. To date, there have been four case reports of penile injections—the indications being evenly split between the treatment of impotence/sexual inadequacy and augmentation. The most recent description was published in 1982. We present a case of debilitating silicone granuloma of the penis and scrotum secondary to large-volume injections into the corpora cavernosae and penile soft tissues administered in Belgium 14 years prior to presentation. The development of a silicone foreign body reaction, massive edema, and subsequent impotence lends itself to a clinical diagnosis and aggressive treatment with wide local excision and appropriate soft-tissue coverage. The metabolic fate of silicone in vivo remains inadequately characterized and a fertile area for research as new methods involving nuclear magnetic resonance spectroscopy have been devised to identify silicone and highly coordinated silicone complexes.
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