Objective To explore the effect of autologous fat transplantation and type A botulinum toxin in the treatment of facial depression after liposuction. Methods A total of 64 patients with facial depression after liposuction admitted to plastic surgery of our hospital from April 2020 to April 2022 were randomly divided into control group and observation group, with 32 cases in each group. The control group was treated with autologous fat transplantation, and the observation group was treated with autologous fat transplantation combined with type A botulinum toxin. The clinical efficacy, complications and adipose tissue necrosis were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.88%, which was higher than 81.25% in the control group (P0.05). Conclusion Autologous fat transplantation combined with toxin A botulinum injection can guarantee the safety of patients with facial depression after liposuction, improve the facial depression, improve the smoothness and beauty of the face, and promote the survival of fat transplantation.