Abstract:Objective: To assess the effect of A-type botulinum toxin (BTX-A) injection combined with cross-linked hyaluronic acid (CL-HA) filling on facial symmetry and FACE-Q satisfaction in mid-face aging patients.Methods: Data from 60 patients treated for mid-face aging between March 2023 and March 2025 were analyzed. Patients were divided into two groups: control (30 cases, CL-HA filling) and observation (30 cases, BTX-A + CL-HA). Facial symmetry, FACE-Q appearance, and treatment satisfaction were compared pre- and post-treatment.Results: After treatment, the observation group showed significantly lower mouth corner deviation (2.03 ± 0.41 mm), cheek height difference (1.15 ± 0.32 mm), and nasolabial fold depth difference (0.52 ± 0.18 mm) than the control group (P < 0.05). The observation group also had higher FACE-Q scores (appearance: 78.46 ± 6.13, skin quality: 75.82 ± 5.97, psychological/social function: 80.15 ± 7.24) and higher treatment satisfaction (96.67% vs. 76.67%, P < 0.05).Conclusion: BTX-A injection with CL-HA filling improves facial symmetry and satisfaction, showing clinical value.