Objective To compare the clinical effects of silicone prosthesis implantation and hyaluronic acid injection in cosmetic rhinoplasty. Methods A total of 483 patients who underwent rhinoplasty in Guizhou Plastic and Oral Cosmetic Surgery Hospital from April 2017 to June 2022 were selected as the research objects. According to the di?erent materials used in rhinoplasty, they were divided into control group (n=241) and observation group (n=242). The control group was given silicone prosthesis implantation, and the observation group was given hyaluronic acid injection. The rhinoplasty e?ect, pain degree, comfort degree, rhinoplasty maintenance rate and complication were compared between the two groups. Results There was no signifcant di?erence in the nasal tip sti?ness score, nasal appearance beauty score, nasal height satisfaction score between the two groups (P>0.05). There was no di?erence in the VAS score and BCS score between the two groups (P>0.05). There was no signifcant di?erence in the maintenance rate of rhinoplasty between the two groups (P>0.05). The incidence of complications in the observation group was 3.31%, which was lower than 12.03% in the control group (P<0.05). Conclusion Both silicone prosthesis implantation and hyaluronic acid injection have good e?ects in rhinoplasty, but the latter has higher safety and can e?ectively reduce the incidence of postoperative complications.