Hematic, or “chocolate,” cysts are accumulations of blood and its breakdown products within cystic spaces. They have been reported as being associated with lesions having cystic spaces (lymphangiomas, hemangiomas), spontaneously and immediately following trauma. We report a patient who had a blow-out fracture repair 21 years before the discovery of her chocolate cyst. She had been free of symptoms for the first 10 years after her orbital floor repair. She then developed signs of recurrent myositis with increasing symptoms, which finally led to surgical intervention. At surgery the migration of the silicone implant produced the chocolate cyst.