Objective To compare the effect of hyaluronic acid injection and silicone prosthesis implantation in rhinoplasty. Methods A total of 82 patients who underwent rhinoplasty in the Department of Plastic Surgery, the First Affiliated Hospital of Guangdong Pharmaceutical University from June 2022 to June 2023 were selected as the research objects. According to different treatment methods, they were divided into silicone prosthesis group (n =41) and hyaluronic acid group (n =41). The silicone prosthesis group was implanted with silicone prosthesis for rhinoplasty, and the hyaluronic acid group was injected with hyaluronic acid for rhinoplasty. The maintenance rate of rhinoplasty effect, surgical satisfaction and complication rate were compared between the two groups. Results The maintenance rate of rhinoplasty in the hyaluronic acid group was 85.37%, which was higher than 78.05% in the silicone prosthesis group, but the difference was not statistically significant (P >0.05). The scores of surgical discomfort, nasal back stiffness, naturalness, nasal tip stiffness, and pain in the hyaluronic acid group were better than those in the silicone prosthesis group, and the differences were statistically significant (P <0.05). The incidence of complications in the hyaluronic acid group was 4.88%, which was lower than 12.20% in thesilicone prosthesis group, and the difference was statistically significant (P <0.05). Conclusion The application of hyaluronic acid injection and silicone prosthesis implantation in rhinoplasty can maintain good rhinoplasty effect, but the application safety of hyaluronic acid injection is high, which can not only make the nose shape quickly and naturally, but also improve patient satisfaction.