Objective To explore the application effect of forehead small incision rhytidectomy combined with elastic thread lifting in facial rejuvenation plastic surgery. Methods A total of 80 patients who underwent facial rejuvenation plastic surgery in the Department of Aesthetic Surgery, Beijing Albeid Medical Beauty Hospital from December 2020 to December 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with traditional large-incision forehead rhytidectomy combined with conventional thread lifting, and the observation group was treated with forehead small incision rhytidectomy combined with elastic thread lifting. The aesthetic effect, surgical indicators, complication rate and appearance satisfaction were compared between the two groups. Results The wrinkle improvement score and skin tightness score of the observation group were higher than those of the control group (P<0.05). The operation time and postoperative swelling subsidence time of the observation group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group (P<0.05). The incidence of complications in the observation group (5.00%) was lower than that in the control group (20.00%) (P<0.05). The appearance satisfaction rate of the observation group (97.50%) was higher than that of the control group (82.50%) (P<0.05). Conclusion Forehead small incision rhytidectomy combined with elastic thread lifting has a deffnite application effect in facial rejuvenation. It can effectively improve wrinkles and skin tightness, shorten operation time and postoperative swelling subsidence time, reduce the incidence of complications, and improve appearance satisfaction.