its basically impossible to remove, but can be shaved down just like overly prominent bone can. think kylie jenner before and after having her jaw shaved down. The level of osseointegration in HA paste is better than any other alloplastic material AFAIK.
It dosnt work for the jaw cuz the granules migrate, but for the midface its very promising. my understanding was that only small augmentations can be made successfully? perhaps this is untrue.
I think the puffyness plosko is refering to is the residual swelling. the granules are rough and irritate the periostium for quite some time, from what ive seen from gunsons patients.