Objective To explore the application effect of small incision facial rhytidectomy combined with autologous fat facial filling in facial rejuvenation surgery. Methods A total of 78 patients with facial rejuvenation surgery admitted to our hospital from January to December 2021 were selected as the research objects. They were randomly divided into control group and observation group, with 39 cases in each group. The control group was treated with small incision facial rhytidectomy, and the observation group was treated with small incision facial rhytidectomy + autologous fat facial filling. The facial quantitative indicators, complication rate, clinical efficacy and satisfaction were compared between the two groups. Results After treatment, the distance from the pupil point to the intersection of the nasolabial groove and the pupil vertical line in the two groups was shorter than that before treatment, and that in the observation group was shorter than that in the control group, while the ABC radian was smaller than that before treatment, and that in the observation group was smaller than that in the control group, the difference was statistically significant (P0.05). The total incidence of complications in the observation group was higher than that in the control group, but the difference was not statistically significant (P>0.05). The excellent and good rate of the observation group was higher than that of the control group after 1 week and 1 year, and the difference was statistically significant（P<0.05). The satisfaction of the observation group was higher than that of the control group at 1 week and 1 year after operation, and the difference was statistically significant (P<0.05). Conclusion The use of small incision facial rhytidectomy combined with autologous fat facial filling for facial rejuvenation surgery has ideal short-term and long-term effects, high patient satisfaction, and will not increase the incidence of complications. It is worthy of clinical application.