Objective To observe the application effect of dexmedetomidine, dezocine and propofol combined with tumescent anesthesia in autologous fat facial filling. Methods A total of 42 patients who received autologous fat facial filling in Dongguan One and Only Plastic Cosmetic Hospital from October 2021 to December 2023 were selected as the research objects and divided into control group and experimental group according to the random number table method, with 21 patients in each group. The control group was treated with propofol+sufentanil+tumescent anesthesia, and the experimental group was treated with dezocine+ dexmedetomidine+propofol+tumescent anesthesia. The PRST score, postoperative Aldrete score and PADS score were compared between the two groups. Results The PRST score of the experimental group was [0.00(0.00, 0.00)]score, which was lower than that of the control group [2.00(1.00, 3.00)]scores (P <0.05). There was no significant difference in Aldrete score between the two groups at 5, 10 and 15 min after operation (P >0.05). The postoperative 1 h PADS score of the experimental group was [9.00(9.00, 9.00)] scores, which was higher than [8.00(8.00, 9.00)] of the control group (P <0.05), but there was no significant difference in the PADS score between the experimental group and the control group at 2, 3, 4 and 6 h after operation (P >0.05). Conclusion Tumescent anesthesia combined with dexmedetomidine, dezocine and propofol for autologous fat facial filling can reduce the PRST score and improve the postoperative 1 h PADS score. Meanwhile, it has high application value in promoting the rapid recovery and discharge of patients, which is an ideal anesthesia method.