Silicone implants have been used for breast augmentations, both cosmetically and in reconstructive surgery since the 1960s. Rupture of breast implants and silicone migration is a well-known complication. In this case report and literature review, we present a case of a 53-year-old woman with bilateral cosmetic silicone gel breast implant in 1986, and a replacement with saline gel in 2005. The patient had no breast complaints and observed no change in breast volume during this period. In 2020, silicone was randomly identified in a right-sided cervical lymph node in an attempt to remove suspicious lymphadenopathy. The source of the silicone is still doubted; that is, it is not known if the silicone originated from the saline implant or the silicone gel implant. In our literature review, we find that distant migration of silicone and lymphadenopathy have occurred for silicone breast implants although very rare for saline gel breast implants.