To investigate the shaping effect of autologous fat granule transplantation and prosthesis for breast augmentation. Methods A total of 48 patients who underwent breast augmentation surgery in Guangzhou Yuandong Aesthetic Hospital from January 2018 to January 2022 were selected as the research objects. They were divided into control group and study group by random number table method, with 24 patients in each group. The control group was treated with conventional prosthesis for breast augmentation surgery, and the study group was treated with autologous fat granule transplantation for breast augmentation surgery. The changes of C-reactive protein (CRP) level at admission, 1 day before operation, 1 day after operation and 2 days after operation, operation time, chest circumference increase, clinical efficacy, postoperative complications and shaping effect satisfaction were compared between the two groups. Results The level of CRP in the study group was lower than that in the control group at 1 and 2 days after operation (P <0.05). The operation time of the study group was shorter than that of the control group, and the increase of chest circumference was higher than that of the control group (P <0.05). The total effective rate of treatment in the study group was 91.67%, which was higher than 66.67% in the control group (P <0.05). The satisfaction rate of shaping effect in the study group was 91.67%, which was higher than 66.67% in the control group (P <0.05). The incidence of postoperative complications in the study group was 0, which was lower than 25.00% in the control group (P <0.05). Conclusion The shaping effect of autologous fat granule transplantation for breast augmentation is better than that of prosthesis. It can not only increase the chest circumference, but also improve the clinical efficacy, strengthen the satisfaction of patients with shaping effect, and has fewer postoperative complications and higher safety.