Siliconoma represents a granulomatous foreign body reaction to silicone, which is often used for soft tissue augmentation. Although considered as biologically inert for a long time, silicone has been implicated in various undesirable local and systemic reactions, sometimes with a latency period of up to several decades. Treatment of siliconomas is difficult and granulomas involving the face are a therapeutic challenge. We present a 43-year-old woman with a severely disfiguring facial silicone granuloma who was successfully treated with minocycline.