The use of permanent fillers for aesthetic enhancement has led to significant complications in Western Europe, particularly in France, where cases continue to emerge despite stricter regulations and the withdrawal of many products from the market. Plastic surgeons can sometimes improve complications outcomes, reversing the damage caused by polymethacrylate, polyacrylamide, silicone, or paraffin injections is rarely possible. Complications such as migration, induration, inflammatory granulomas, and chronic infections often manifest months or years after injection, posing serious medical and surgical challenges. Initial treatment relies on corticosteroid injections and prolonged antibiotic therapy for small inflammatory lesions, but recurrence is common, leading to dependency on steroids and increasing the risk of skin atrophy, terrible with facial lesions. In severe cases, infection leading to tissue necrosis and fistulas, surgical removal is required, which may result in scarring, deformities, or functional impairment, particularly in facial and genital applications. Buttock and breast augmentations with permanent fillers have proven particularly problematic and dramatic, with patients presenting with painful swelling, infections, and deep tissue migration, often necessitating extensive excisions and repetitive treatments. Imaging techniques such as ultrasound and magnetic resonance imaging (MRI) play a crucial role in identifying implant pockets, but complete removal remains difficult, especially in cases of deep tissue infiltration and disintegration and fragmentation of the filler in multiple vesicles. Although Western Europe has largely phased out these fillers, they remain in circulation in certain regions, especially through medical tourism and unregulated markets. The persistence of these complications underscores the urgent need for patient education, tighter regulations, and safer alternatives. This chapter provides insights from Western Europe, highlighting the long-term consequences of permanent fillers and the evolving strategies for managing their complications.