To explore the effect of facial liposuction combined with fat transplantation in improving the facial contour. Methods A total of 80 patients who underwent facial contour plastic surgery in Nanjing Rly Medical Beauty Clinic from April 2022 to April 2023 were selected as the research objects. They were divided into control group and study group according to the random number table method, with 40 patients in each group. The control group was treated with facial liposuction, and the study group was treated with facial liposuction combined with fat transplantation. The clinical efficacy, facial contour improvement, complications and satisfaction were compared between the two groups. Results The total effective rate of treatment in the study group was 95.00%, which was higher than 80.00% in the control group (P <0.05). The excellent and good rate of facial contour roundness improvement and the excellent and good rate of facial contour hand feeling improvement in the study group were higher than those in the control group (P <0.05). The incidence of complications in the study group was 2.50%, which was lower than 17.50% in the control group (P <0.05). The satisfaction rate of the study group was 97.50%, which was higher than 85.00% of the control group (P <0.05). Conclusion Facial liposuction combined with fat transplantation is effective in improving facial contour, which can improve facial aesthetics, effectively improve facial contour roundness and hand feeling, and has fewer postoperative complications and higher patient satisfaction.