Permanent synthetic filler disease (PSFD) represents a growing public health concern in Spain, driven by immigration from regions where nonabsorbable fillers are more prevalent. This descriptive cross-sectional study analyzes the clinical profiles and surgical outcomes of 149 patients treated in Barcelona between January 2021 and January 2023. Survey responses from 35 surgically treated patients revealed a mean latency of 14.9 years from injection to symptom onset, with arthralgias and pain being most frequent. The majority of procedures was performed by non-medical personnel in Latin America. Exploratory surgery led to symptomatic improvement in 73.1% of cases. Findings highlight the late-onset nature of PSFD, the importance of a multidisciplinary approach, and the potential benefits of surgical intervention. Enhanced awareness among healthcare professionals is vital for early recognition and appropriate management of this condition.