Objective To observe the effect of hyaluronic acid combined with type A botulinum toxin injection on periocular wrinkle improvement after periocular rejuvenation surgery. Methods From August 2023 to August 2024, 80 patients who underwent periocular rejuvenation surgery in the Department of Cosmetic Surgery, Shenzhen Number One Meidu Medical Beauty Clinic were selected as the research subjects. According to the random number table method, they were divided into the the control group and the study group, with 40 patients in each group. The control group received the conventional periocular rejuvenation surgery treatment plan, and the study group received hyaluronic acid combined with type A botulinum toxin injection on the basis of the control group. The periocular wrinkle improvement, periocular skin quality improvement, facial aesthetic scores, rehabilitation time, treatment satisfaction and adverse reactions were compared between the two groups. Results The total effective rate of periocular wrinkle improvement in the study group was 95.00%, which was higher than 75.00% in the control group (P <0.05). Compared with the control group, the scores of elasticity, moisture, dark spots and oil in the study group after treatment were better (P <0.05). Compared with the control group, the subjective and objective facial aesthetic scores in the study group after treatment were higher (P <0.05). Compared with the control group, the rehabilitation time in the study group was shorter, the treatment satisfaction score was higher (P <0.05). The incidence of adverse reactions in the study group was 2.50%, which was lower than 15.00% in the control group (P <0.05). Conclusion The combined injection of hyaluronic acid and type A botulinum toxin after periocular rejuvenation surgery can not only improve patients' periocular wrinkles and skin quality, accelerate the postoperative rehabilitation period, but also reduce the incidence of a series of postoperative adverse reactions, and improve the overall facial aesthetics and satisfaction of patients.