Objective: To explore the clinical effect of prosthesis removal combined with autologous fat filling in the repair of postoperative deformities after rhinoplasty, and to analyze the improvement effect of this procedure on the smoothness of the patient's nasal dorsum and the overall appearance of the nose. Method: 66 patients with postoperative deformities after rhinoplasty in our hospital from January 2025 to June 2026 were randomly divided into two groups, with 33 patients in each group. The control group underwent simple prosthesis removal surgery, while the observation group underwent prosthesis removal combined with autologous fat filling repair. The clinical efficacy, nasal dorsum fluency, satisfaction, and complications of the two groups were compared. The observation group had a higher overall clinical repair efficiency, nasal dorsum fluency score, and patient satisfaction with nasal appearance compared to the control group, and had a lower incidence of postoperative complications, P＜0.05。 Conclusion: The combination of prosthesis removal and autologous fat filling for post rhinoplasty deformity repair can effectively correct nasal deformities, significantly improve the smoothness of nasal dorsal lines, optimize the overall aesthetic shape of the nose, and can be promoted and applied as the preferred surgical method for post rhinoplasty deformity repair.