Objective To compare the clinical effects of polymethyl methacrylate (PMMA) injection and silicone prosthesis implantation in rhinoplasty. Methods From September 2021 to May 2023, 83 patients with rhinoplasty admitted to Suzhou Mylike Cosmetic Hospital were selected as the observation objects. The patients were divided into control group (n =41) and observation group (n =42) according to the random number table method. The control group underwent silicone prosthesis implantation, and the observation group underwent PMMA injection rhinoplasty. The rhinoplasty effect, 1-year maintenance rate and complication rate were compared between the two groups. Results The scores of nasal comfort and nasal shape satisfaction in the observation group were higher than those in the control group, the score of surgical pain was lower than that in the control group, and the recovery time was shorter than that in the control group (P <0.05). The nasal maintenance rate of the observation group was slightly lower than that of the control group, but the difference was not statistically significant (P >0.05). The incidence of complications in the observation group was lower than that in the control group within 1 year after operation (P <0.05). Conclusion In rhinoplasty, PMMA injection can achieve a nasal shape maintenance rate similar to that of silicone prosthesis implantation, and it can improve the patient's nasal comfort and nasal shape satisfaction, reduce the degree of surgical pain, and has high safety.