To explore the application effect of autologous fat transplantation combined with type A botulinum toxin injection in facial rejuvenation. Methods A total of 80 patients with facial rejuvenation admitted to Xi'an Shunmei Medical Beauty Clinic from May 2020 to May 2023 were selected as the research objects. They were divided into control group and study group according to different treatment schemes, with 40 patients in each group. The control group was given autologous fat transplantation, and the study group was combined with type A botulinum toxin injection. The clinical efficacy, facial contour parameters, skin condition and self-confidence, and treatment satisfaction were compared between the two groups. Results The total effective rate of treatment in the study group was 92.50%, which was higher than 72.50% in the control group (P <0.05). The improvement of facial contour parameters in the study group were better than those in the control group (P <0.05). After treatment, the skin condition and BES score of the study group were better than those of the control group (P <0.05). The satisfaction of the study group was 95.00%, which was higher than 75.00% of the control group (P <0.05). Conclusion The combined application of autologous fat transplantation and type A botulinum toxin injection can effectively improve the facial contour and skin condition in facial rejuvenation, with higher therapeutic effect and patient satisfaction, and has high clinical application value.