Objective To explore the effect of thread lifting combined with hyaluronic acid fflling on the improvement of wrinkles and depressions in patients with mid and lower facial aging. Methods A total of 62 patients with mid and lower facial aging treated in Miluo Weifu Medical Aesthetic Clinic from February 2024 to April 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 31 patients in each group. The control group was treated with hyaluronic acid fflling, and the observation group was treated with thread lifting on the basis of the control group. The mid and lower facial laxity score, facial contour aesthetic score, improvement of wrinkles and depressions, and clinical efffcacy were compared between the two groups. Results At 3 months after treatment, the mid and lower facial laxity score of the observation group was lower than that of the control group (P<0.05). At 3 months after treatment, the facial contour aesthetic score of the observation group was higher than that of the control group (P<0.05). At 3 months after treatment, the improvement of wrinkles and depressions in the observation group was better than that in the control group (P<0.05). The total effective rate of the observation group (93.55%) was higher than that of the control group (77.42%) (P<0.05). Conclusion Thread lifting combined with hyaluronic acid fflling can effectively alleviate facial laxity, wrinkles and depressions of patients with mid and lower facial aging, and improve the aesthetic effect of facial contour.