Injectable fillers for breast augmentation have never gained favor in Australian practice, but have been used widely in Eastern Europe and East Asia. We present our experience of 44-year-old ex-pat who presented with recurrent episodes of mastitis after large volume polyacrylamide filler injection in Singapore 6 years prior to presentation, requiring multiple debridement and implant-based reconstruction, with ongoing problems from symptomatic granulomas. Polyacrylamide fillers have been banned in several countries; copolyamide fillers have been developed more recently and found to be chemically identical to the earlier, banned substance. The typical clinical presentation is one of delayed presentation (usually at least 2 years post-injection) with a variety of complications including recurrent infections, painful granulomas and nodules, breast deformity, and risks of migration of filler material into the pectoral muscles and beyond. It is often not possible to remove all of the injected material so complications risk being long-term, and patients are usually unaware of these risks. Reconstruction will often require implants, typically in the sub-muscular plane as the overlying glandular tissue has been damaged. Concomitant mastopexy and inframammary fold (IMF) supporting procedures may be required in addition.