Permanent filler removal & post removal. What's the best option for adjusting the shape?

There is no way to predict chance of infection or inflammation with permanent fillers.  If you had this in the past and are getting more fillers now, I always have my patients start an oral antibiotic for at least 6 weeks and use topical mupirocin to their nares.  They wash with an antibacterial soap as well.  you are taking a chance with any permanent filler, including the use of fat, which in my opinion is very safe and effective if injected properly and sterilly.  I suggest only going to a filler expert who will be honest with you about your goals.  Best, Dr. Emer.

Complications and cosmetic dissatisfaction after permanent fillers is a tough situation.  Unfortunately I am faced with it frequently.  Factors to consider include the nature of the permanent filler, the aesthetic concerns, and nature of the complications and side effects of additional treatment, etc. As these issues are typically not straightforward and each case is individual, I would suggest consultation with a physician who is experienced in treating patients who face these issues.

It would depend on what permanent filler you had.  There are some FDA approved and non approved fillers that have been used in the US.  It is important that you discuss with your injector what product you had and what options are there.  If they are not a qualified MD would recommend that you seek a consult by a board certified specialist.