Objective To analyze the effect of hydrodynamic assisted liposuction on breast aesthetics in patients undergoing autologous fat transplantation for breast augmentation. Methods A total of 40 patients who underwent autologous fat transplantation for breast augmentation in the Second People's Hospital Affiliated to China Three Gorges University/the Second People's Hospital of Yichang from January 2022 to October 2024 were selected. According to the random number table method, they were divided into the control group and the observation group, with 20 patients in each group. The control group received autologous fat transplantation for breast augmentation, and the observation group received hydrodynamic assisted liposuction on the basis of the control group. The breast aesthetics, clinical efficacy, surgical indexes and complication rate were compared between the two groups. Results The breast aesthetics in the observation group was 90.00%, which was higher than 50.00% in the control group (P <0.05). The total effective rate in the observation group was 95.00%, which was higher than 70.00% in the control group (P <0.05). The increase in breast volume, liposuction time and survival rate of transplanted fat in the observation group were better than those in the control group (P <0.05). The incidence of complications in the observation group was 5.00%, which was lower than 35.00% in the control group (P <0.05). Conclusion Hydrodynamic assisted liposuction can improve the efficiency of breast augmentation in patients undergoing autologous fat transplantation for breast augmentation, enhance the breast aesthetics, and reduce the incidence of complications, which is worthy of clinical application.