Recurrent Superficial Thrombophlebitis Secondary to Migrated Silicone: A Diagnostic Challenge

Background: Lower extremity swelling is a common clinical presentation with a broad and overlapping differential diagnosis. Although recurrent cellulitis may be commonly seen in such cases, the coexistence of migratory superficial venous thrombophlebitis and chronic edema is uncommon, particularly in the absence of varicose veins. Delayed complications of cosmetic silicone fillers are increasingly recognized; however, vascular manifestations remain rare. Case Summary: We report a 39-year-old woman with a 3-year history of recurrent bilateral lower extremity edema, cellulitis, and migratory superficial thrombophlebitis. Extensive evaluation excluded infectious, lymphatic, cardiac, renal, hepatic, malignant, autoimmune, and hypercoagulable causes. Duplex ultrasonography revealed “snowstorm” echogenicity, and magnetic resonance imaging confirmed migrated silicone deposits in the lower extremities. Surgical removal resulted in complete symptom resolution. Take-Home Messages: Delayed silicone migration can induce chronic inflammatory and vascular complications, posing a diagnostic challenge and mimicking recurrent cellulitis. This case highlights the multifactorial complexity of chronic lower extremity swelling and the importance of multidisciplinary evaluation.