Soft tissue calcifications are a common imaging finding, but in the setting of a cosmetic augmentative injection and hypercalcemia, it may be pathognomonic for lipogranuloma, a delayed granulomatous inflammatory reaction to the injected foreign material. Although diagnosis of lipogranuloma is based on the results of histopathologic examination, the radiologist may play a key role in the clinical evaluation of challenging cases when patients do not report about nonmedical cosmetic procedures. If the treatment of granulomatosis-induced hypercalcemia is not timely, it may result in chronic renal disease and other comorbidities. We report a case of lipogranuloma with extensive subcutaneous calcification and hypercalcemia associated with cosmetic injection.