Objective To study the effect of middle and lower facial line carving combined with local injection filling in facial rejuvenation and its influence on skin condition. Methods From January 2021 to January 2024, 60 patients who underwent facial rejuvenation in the Beauty and Dermatology Department of Guanshan Lake Ke Long Xiaoke Beauty Clinic were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with local injection filling, and the observation group was treated with middle and lower facial line carving combined with local injection filling. The skin state, psychological state, quality of life and adverse reactions were compared between the two groups. Results The scores of postoperative skin moisture and elasticity in the observation group were higher than those of the control group, and the scores of oil and dark spots were lower than those in the control group (P <0.05). The scores of SAS and SDS in the observation group were lower than those in the control group (P <0.05). The scores of all dimensions of quality of life in the observation group were higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 6.67%, which was lower than 30.00% in the control group (P <0.05). Conclusion The application effect of middle and lower facial line carving combined with local injection filling in facial rejuvenation is definite, the anti-aging effect and aesthetic effect are good. It can effectively improve the skin texture and reduce wrinkles, with fewer adverse reactions and higher safety after treatment. Meanwhile, it is beneficial to improve the psychological state and quality of life of patients, which is worthy of clinical application.