Background and AimsThe preference of beauty seekers for noninvasive, convenient, and long‐lasting effective facial cosmetic techniques with minimal downtime and recovery time is obvious nowadays. As a part of traditional Chinese medicine, acupuncture has great advantages in solving these problems. This study aims to assess the effectiveness of two distinct acupuncture techniques for facial rejuvenation in treating nasolabial folds (NFs) and marionette lines (MLs).MethodsOne hundred beauty seekers who have received facial acupuncture cosmetic treatment in hospitals between June 1, 2020, and December 31, 2022, were selected randomly and inquired. Among them, 50 beauty seekers (Group Ⅰ) have received a normal facial traditional Chinese medicine acupuncture therapy, by inserting the needles perpendicularly into the acupoints. Meanwhile, another 50 beauty seekers (Group Ⅱ) were treated by needle knives, which were inserted parallelly under the dermis and basically along the meridians of Chinese medicine linked by the acupoints. The records of pain evaluation and adverse events on cases, subjective satisfactions, and objective evaluations of efficacy were summarized and statistically analyzed.ResultsThe efficacy of Group Ⅱ is better than Group Ⅰ. The dermatologists' assessments for NF and ML show significant differences between Groups Ⅰ and Ⅱ after one course. The mean value of subjective satisfaction also obeys the rules above. Although Group Ⅱ exhibited the highest value of mean pain intensity, the adverse events were basically mild. Furthermore, Group Ⅱ showed higher willingness for additional treatments.ConclusionOnly in terms of the wrinkle depth of NF and ML, the method of acupuncturing parallelly under the dermis by needle knife is safe and more successful.