Objective To compare the aesthetic shaping effects of autologous fat granule grafting for breast augmentation and prosthetic breast augmentation. Methods A total of 65 patients with breast augmentation needs admitted to Xinjiang Limei Medical Beauty Clinic from January 2020 to December 2021 were selected as the research subjects, and they were divided into the control group (32 patients) and the observation group (33 patients) by the random number table method. The control group was given prosthetic breast augmentation, and the observation group was given autologous fat granule grafting for breast augmentation. The surgical indicators, aesthetic shaping effect, complications and satisfaction with aesthetic shaping were compared between the two groups. Results The operation time of the observation group [(49.24±9.34)min] was shorter than that of the control group [(58.05±10.13)min], and the chest circumference increase of the observation group was greater than that of the control group (P <0.05). The total effective rate of surgery in the observation group (93.94%) was higher than that in the control group (75.00%) (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05). The satisfaction with aesthetic shaping in the observation group (90.91%) was higher than that in the control group (65.63%) (P <0.05). Conclusion In breast augmentation surgery, autologous fat granule grafting has a shorter operation time than prosthetic breast augmentation, wit h a greater chest circumference increase, better sur gical effects, lower incidence of postoperative complications, and higher patient satisfaction.