Objective To explore the effect of liposuction combined with linear lifting technique in lower and middle facial rejuvenation. Methods A total of 76 patients with moderate to severe facial aging admitted to Xi'an Yue Xinyan Medical Cosmetology Clinic from July 2021 to July 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the experimental group, with 38 patients in each group. The control group received linear lifting treatment, and the experimental group received liposuction combined with linear lifting treatment. The nasolabial fold improvement, oral commissure pouch improvement, deep fat pad repositioning and treatment effect were compared between the two groups. Results After treatment, the depth and length of the nasolabial folds in the experimental group were smaller than those in the control group (P <0.05). The improvement rates of the oral commissure pouch protrusion volume, sagging degree, skin tightness and integration with surrounding tissues in the experimental group were all higher than those in the control group (P <0.05). The proportion of good anatomical position restoration, ideal volume maintenance, and positive impact on surrounding tissues in the experimental group were all higher than those in the control group (P <0.05). The total effective rate of treatment in the experimental group (97.37%) was higher than that in the control group (81.58%) (P <0.05). Conclusion The application of liposuction combined with linear lifting technique in lower and middle facial rejuvenation has a good effect on improving facial aging. It can effectively reduce nasolabial folds and oral commissure pouches, promote the repositioning of deep fat pads, which is worthy of clinical application.