Objective To investigate the effect of autologous fat combined with platelet-rich plasma (PRP) therapy on facial aesthetics satisfaction in patients with facial depressed scar. Methods A total of 84 patients with facial depressed scar admitted to our hospital from December 2023 to June 2025 were selected. According to the random number table method, they were divided into the control group (n=42) and the study group (n=42). The control group was treated with autologous fat, and the study group was treated with autologous fat combined with PRP. The clinical indicators, scar symptoms, facial aesthetic satisfaction and complication rate were compared between the two groups. Results The duration of incrustation, erythema and pain in the study group was shorter than that in the control group (P<0.05). The ECCA score in the study group at 3 months after operation was lower than that in the control group (P<0.05). The facial aesthetic satisfaction rate in the study group was 97.62%, which was higher than 80.95% in the control group (P<0.05). There was no signiffcant difference in the incidence of complications between the two groups (P>0.05). Conclusion Autologous fat combined with PRP therapy for facial depressed scar can shorten the duration of incrustation, erythema and pain, improve scar symptoms, enhance facial aesthetics satisfaction, and does not increase the incidence of complications.