This transgender woman developed unexpected complications decades after undergoing a cheap but unsafe gender-affirming treatment.

In adolescence, she had received free liquid silicone injections directly into the soft tissue of her chest — a treatment attractive to patients who could not afford breast implants, according to her doctors.

Writing in BMJ Case Reports, they said the patient came to them complaining of pain, breast induration and overlying skin discolouration, all of which were confirmed on examination and consistent with chronic inflammatory changes.

There was no family history of breast cancer. The differential diagnosis on presentation included silicone granulomas, fat necrosis and malignancy.