Silicone is considered a biocompatible material, and therefore has many applications in medicine. It can be used in a liquid form for subcutaneous injection, in gel form for implants, and in a solid state for prostheses, hemodialysis tubing, etc. The use of injectable liquid silicone for tissue augmentation is widespread, but there are many reports of side effects, some severe and debilitating such as the granulomatous reaction. We report on a patient with an upper lip swelling, who denied having been subjected to any type of lip augmentation. An incisional biopsy was taken, and the pathologist reported an atypical lyphomatous tumor. The patient was informed that a wide excision of the lip was necessary, and then she confessed she underwent silicone injections in the past. This is a case of a granulomatous reaction after silicone injection in the lip. The article also reviews the literature on the subject.