Objective To explore the effect of hyaluronic acid filling injection in facial contour remodeling. Methods A total of 80 patients with low facial contour admitted to Shanghai Laiyan Medical Beauty Clinic from August 2022 to August 2023 were randomly divided into control group and study group, with 40 patients in each group. The control group was treated with autologous fat granule filling injection, and the study group was treated with hyaluronic acid filling injection. The clinical efficacy, contour remodeling effect, treatment satisfaction and complications were compared between the two groups. Results The total effective rate of treatment in the study group was 97.50%, which was higher than 82.50% in the control group (P <0.05). The width of the lower face after filling in the study group was smaller than that in the control group, and the ratio of the lower face contour was higher than that in the control group (P <0.05). There was no significant difference in the length of the lower face between the two groups (P >0.05). The treatment satisfaction of the study group was 95.00%, which was higher than 77.50% of the control group (P <0.05). The incidence of complications in the study group was 5.00%, which was lower than 20.00% in the control group (P <0.05). Conclusion The effect of hyaluronic acid filling injection on improving facial contour is better than that of autologous fat granule filling injection, which is beneficial to reduce the width of the lower part of the face and improve the ratio of the lower part of the face. Meanwhile, the incidence of complications after treatment is low, and the patient satisfaction is high.