To explore the effect of plastic and cosmetic surgery in the repair of facial soft tissue trauma. Methods A total of 60 patients with facial soft tissue trauma admitted to Western Beijing Cancer Hospital from June 2022 to June 2023 were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with conventional facial repair, and the observation group was treated with plastic and cosmetic surgery. The surgical related indicators, treatment outcomes and complications were compared between the two groups. Results The intraoperative blood loss, operation time and discharge observation time of the observation group were better than those of the control group (P <0.05). The proportion of stage I healing and scarless hyperplasia in the observation group was higher than that in the control group, and the proportion of stage Ⅱ plastic surgery was lower than that in the control group (P <0.05). The complication rate of the observation group was 6.67%, which was lower than 26.67% of the control group (P <0.05). Conclusion The clinical effect of plastic and cosmetic surgery in repairing facial soft tissue trauma is good, which can effectively improve the surgical related indicators and treatment outcomes, and the incidence of adverse reactions after repair is low, and the safety is high, which is worthy of clinical application.