Objective To explore the effect of autologous facial fat filling technique combined with facial rhytidectomy on facial aesthetic effect and sagging condition in patients undergoing facial rejuvenation surgery. Methods A total of 78 patients who underwent facial rejuvenation surgery treatment in our hospital from January 2021 to October 2023 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 39 patients in each group. The control group was treated with facial rhytidectomy, and the observation group was combined with autologous facial fat filling technique on the basis of the control group. The facial aesthetic effect, facial sagging condition and satisfaction were compared between the two groups. Results The facial aesthetic scores of the observation group at 3 and 6 months after treatment were higher than those of the control group (P <0.05). The skin sagging scores of the observation group at 3 and 6 months after surgery were lower than those of the control group (P <0.05). The satisfaction rate of the observation group (97.44%) was higher than that of the control group (79.49%) (P <0.05).Conclusion Autologous facial fat filling technique combined with facial rhytidectomy can effectively improve the facial sagging of patients undergoing facial rejuvenation surgery, has outstanding aesthetic effects, and leads to higher patient satisfaction, which is worthy of clinical application.