Objective To compare the clinical efffcacy of autologous fat granules and nanofat grafting in facial contour restoration. Methods The clinical data of 80 patients who underwent facial contour restoration from January 2023 to October 2025 in Shanghai Pudong New Area Health Care Hospital for Women&Children were retrospectively analyzed. According to different treatment methods, they were divided into the autologous fat group (autologous fat granule grafting) and the nanofat group (nanofat grafting), with 40 patients in each group. The fat graft survival rate at 6 months after operation, levels of vascular endothelial growth factor (VEGF) and basic ffbroblast growth factor (bFGF), and complication rates were compared between the two groups. Results At 6 months after operation, the fat graft survival rate in the nanofat group was (70.43±7.35)%, which was higher than (52.15±8.21)% in the autologous fat group (P<0.05). At 1 month after operation, the levels of plasma VEGF and bFGF in the nanofat group were higher than those in the autologous fat group (P<0.05). There was no signiffcant difference in the incidence of complications between the two groups (P>0.05). Conclusion Compared with autologous fat granule grafting, nanofat grafting achieves a higher fat survival rate and better promotes angiogenesis in facial contour restoration, without increasing the risk of postoperative complications.