Objective To explore the difference between hyaluronic acid injection and silicone prosthesis in cosmetic rhinoplasty. Methods From December 2020 to December 2021, 80 patients undergoing cosmetic rhinoplasty in our hospital were selected as the research objects. They were divided into control group and experimental group by random number table method, with 40 cases in each group. The control group was treated with silicone prosthesis for rhinoplasty, and the experimental group was treated with hyaluronic acid injection for rhinoplasty. The satisfaction of rhinoplasty, nasal morphological indexes, maintenance rate of rhinoplasty at 1 year after operation and incidence of complications were compared between the two groups. Results There was no significant difference in the satisfaction score of rhinoplasty between the two groups (P>0.05). There was no significant difference in nasal length, nasolabial angle, nasal tip angle, nostril long axis angle, nasal dorsum length, columella-lobule ratio, nasal columella height and nasal tip protrusion between the two groups at 15 days after operation (P>0.05). There was no significant difference in the maintenance rate of rhinoplasty between the two groups (P>0.05). The incidence of complications in the experimental group was lower than that in the control group, and the difference was statistically significant (P