Objective To explore the incidence of anxiety in patients with facial aging after facial fat filling combined with lifting surgery, and analyze its influencing factors. Methods A total of 101 patients with facial aging who underwent facial fat filling combined with lifting surgery in the Medical College of Wuhan University of Science and Technology from July 2023 to June 2024 were selected as the research subjects. The Self-Rating Anxiety Scale (SAS) was used to evaluate patients' anxiety at 1 week after surgery, and a SAS score ≥50 was considered as having anxiety symptoms. Clinical relevant data was collected and compared to analyze the factors influencing anxiety after facial fat filling combined with lifting surgery. Results Overall, the patients were mainly middle-aged, female, with associate degree and above, urban residents, and married. Among the 101 patients, 30 patients had anxiety, accounting for 29.70%, including 20 patients with mild anxiety (66.67%), 8 patients with moderate anxiety (26.67%), and 2 patients with severe anxiety (6.67%). Univariate analysis showed that there were statistically significant differences in gender, age, and educational background between the two groups (P<0.05), while there were no statistically significant differences in residence and marital status between the two groups (P >0.05). Multivariate analysis showed that age, gender, and educational background were independent influencing factors of postoperative anxiety (P<0.05). Conclusion The incidence of anxiety in patients after facial fat filling combined with lifting surgery is relatively high. Patients who are older, female, and have lower educational levels are more likely to experience postoperative anxiety, and should be given key attention and psychological intervention.