Objective To explore the efficacy of botulinum toxin A combined with hyaluronic acid for augmentation rhinoplasty analyzed by 3D image system. Methods According to the principle of double-blind randomized grouping, 40 patients received hyaluronic acid rhinoplasty were divided into control group (n=20) and observation group (n=20). Patients in control group were treated with hyaluronic acid injection alone, while patients in observation group were treated with botulinum toxin A combined with hyaluronic acid injection. The absorptivity of hyaluronic acid was recorded by 3D image system. The material absorptivity, effect and incidence of complications after augmentation rhinoplasty in the two groups were statistically analyzed. Results The material absorption rate of the observation group was lower than that of the control group 6 months and 12 months after injection (P<0.05). There was no significant difference in the nasal aesthetic satisfaction and incidence of complications between the two groups (P>0.05). Conclusion Botulinum toxin A combined with hyaluronic acid injection has lower absorption rate and longer duration than hyaluronic acid injection alone.