Objective To analyze the aesthetic satisfaction of type A botulinum toxin masseter injection combined with hyaluronic acid chin injection filling micro-plastic surgery in reshaping the lower 1/3 facial contour. Methods A total of 84 patients who underwent lower 1/3 facial contour reshaping admitted to the Aesthetic Dermatology Department of our hospital from February to June 2024 were selected, and they were divided into the control group (42 patients) and the experimental group (42 patients) according to the order of their admission for treatment. The control group received simple type A botulinum toxin masseter injection, and the experimental group received hyaluronic acid chin injection filling on the basis of the control group. The aesthetic satisfaction, quality of life, psychological state and adverse reactions were compared between the two groups. Results The aesthetic satisfaction rate of the experimental group was 92.86%, which was higher than 71.43% of the control group (P <0.05). The scores of emotional function, social function, physical function and health status in the experimental group were better than those in the control group (P <0.05). The scores of SAS and SDS in the experimental group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the experimental group was 7.14%, which was lower than 28.57% of the control group (P <0.05). Conclusion Type A botulinum toxin masseter injection combined with hyaluronic acid chin injection filling micro-plastic surgery has a definite effect in reshaping the lower 1/3 facial contour. It can improve the aesthetic satisfaction of patients, reduce the risk of adverse reactions, and improve their quality of life and psychological state, which is worthy of clinical application.