Objective To explore the effect of comprehensive minimally invasive surgery on cosmetic efficacy and satisfaction in patients with facial aging. Methods A total of 100 patients with facial aging admitted to Kundulun District Xingyuyan Medical Beauty Clinic from July 2023 to December 2023 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group was given type A botulinum toxin injection, and the observation group was additionally treated with comprehensive minimally invasive surgery. The cosmetic efficacy, facial contour improvement, patient satisfaction and adverse reactions were compared between the two groups. Results The total improvement rate in the observation group (92.00%) was higher than that in the control group (76.00%) (P <0.05). The scores of nasolabial fold morphology, mandibular margin morphology, facial wrinkles and total score in the observation group at 3 and 6 months after treatment were higher than those in the control group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Comprehensive minimally invasive surgery has a good cosmetic effect in patients with facial aging. It can more effectively improve patients' facial contour, enhance satisfaction, and reduce the incidence of adverse reactions, which is worthy of clinical application.