Objective To explore the effect of hyaluronic acid combined with type A botulinum toxin on facial skin condition and body esteem score in patients undergoing facial contour remodeling. Methods A total of 106 patients who underwent facial contour remodeling intervention in Guangzhou Yestar Medical Beauty Hospital from February to March 2024 were selected as the research subjects, and they were divided into the control group and the study group by the random number table method, with 53 patients in each group. The control group was injected with hyaluronic acid, and the study group was injected with hyaluronic acid combined with type A botulinum toxin. The treatment effect, facial contour parameters, facial skin condition, body esteem condition and complications were compared between the two groups. Results The total effective rate of treatment in the study group was 98.11%, which was higher than 84.91% in the control group (P <0.05). The scores of skin dark spots, moisture and elasticity in the s tudy group after treatment were better than those in the control group (P <0.05). The BES score of the study group after treatment was (78.66±7.86)points, which was higher than (65.31±6.52)points of the control group (P <0.05). The lower facial length and lower facial width in the study group after treatment were better than those in the control group (P <0.05). The incidence of complications in the study group after treatment (0) was lower than that in the control group (7.55%) (P <0.05). Conclusion Hyaluronic acid combined with type A botulinum toxin shows good safety and effectiveness in facial contour remodeling. This combined therapy can optimize facial contour, improve skin texture, and enhance patients' body esteem score, which has high clinical application value.