Objective To analyze the efficacy of Fotona4D combined with radiofrequency and injection in facial anti-aging. Methods A total of 243 patients with facial anti-aging treatment admitted to our hospital from August 2020 to July 2021 were selected as the research objects and randomly divided into 121 cases in the control group and 122 cases in the observation group. The control group was treated with radio frequency therapy combined with botulinum toxin type A injection, and the observation group was treated with Fotona4D laser on the basis of the control group. The therapeutic effect, patient satisfaction and skin aging degree of the two groups were compared. Results The total effective rate of the observation group was 100.00%, which was higher than 95.04% of the control group, and the difference was statistically significant (P＜0.05). The satisfaction rate and satisfaction score of the observation group were higher than those of the control group, and the difference was statistically significant (P＜0.05). The proportion of mild patients in the observation group was higher than that in the control group, and the proportion of moderate aging patients was lower than that in the control group, the difference was statistically significant (P＜0.05); there was no significant difference in the proportion of severe patients between the two groups after treatment (P＞0.05). Conclusion Radiofrequency therapy combined with botulinum toxin type A injection and Fotona 4D Pro laser therapy are effective in the treatment of facial antiaging, which can effectively improve facial wrinkles, skin elasticity and hyperpigmented macule, and have high patient satisfaction.