This is a 55 year old woman, mother one one, who had breast augmentation with silicone gel breast implants in 2008. Recently, she developed a spontaneous massive enlargement of the right breast over a 12 hour period. She had severe pain but no redness of the skin, no purplish discoloration, no fever or malaise. The possible causes included acute infection, hematoma, or seroma. She was taken to the operating room for exploration of the right breast pocket and definitive corrective surgery. A ruptured silicone gel implant was found in the right breast pocket, which also was filled with almost a liter of seroma fluid. The ruptured implant and seroma fluid were removed. A complete capsulectomy was performed. The opposite intact breast implant was also removed. Both pockets were irrigated with antibiotics and drain tubes were placed. Fluid cultures were negative, and the breast capsules were benign. The patient healed completely and uneventfully over the course of a few weeks. She is shown before surgery and six weeks post-op.