Objective To explore the effect of fractional laser combined with ffbroblast growth factor on skin ffatness improvement in patients with facial depressed scars. Methods A total of 50 patients with facial depressed scars admitted to the Department of Plastic Surgery, Beijing Fengtai Hospital from February to November 2025 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 25 patients in each group. The control group was treated with fractional laser alone, and the study group was treated with fractional laser combined with ffbroblast growth factor. The scar condition, clinical efffcacy, skin ffatness improvement and satisfaction were compared between the two groups. Results The VSS scores of the study group at 1, 2, 3, 4 and 6 weeks after intervention were lower than those of the control group (P<0.05). The total effective rate of the study group (96.00%) was higher than that of the control group (60.00%) (P<0.05). At 6 weeks after intervention, the scores of pores, skin texture and melanin in the study group were lower than those in the control group (P<0.05). The satisfaction rate of the study group (100.00%) was higher than that of the control group (72.00%) (P<0.05). Conclusion Fractional laser combined with ffbroblast growth factor in the treatment of facial depressed scars can improve the therapeutic efffcacy, optimize scar status and skin ffatness, and achieve higher patient satisfaction.