Objective To discuss the application effect of plastic and cosmetic surgery repair in patients with facial soft tissue injury. Methods From March 2021 to March 2023, 60 patients with facial soft tissue injury admitted to Zhangfeng Town Central Hospital of Juye County were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with conventional repair methods, and the observation group was treated with plastic and cosmetic surgery repair methods. The repair effect, deformity rate, scar rate, skin function score, repair satisfaction and complications were compared between the two groups. Results The total effective rate of clinical repair in the observation group was 93.33%, which was higher than 73.33% in the control group (P<0.05). The incidence of deformity (3.33%) and scar (0) in the observation group were lower than those in the control group (23.33%, 20.00%). The skin function score of the observation group was higher than that of the control group (P<0.05). The repair satisfaction of the observation group was 90.00%, which was higher than 66.67% of the control group (P<0.05). The incidence of complications in the observation group was 0, which was lower than 16.67% in the control group (P<0.05). Conclusion The repair of plastic and cosmetic surgery for patients with facial soft tissue injury can effectively improve the clinical repair effect, reduce the incidence of complications, avoid deformity and scar after repair, improve the skin function, improve the satisfaction of patients with repair, and have high clinical application value.