Objective To observe the application effect of plastic and cosmetic surgery in the treatment of facial trauma in emergency patients. Methods A total of 80 patients with emergency facial trauma admitted to our hospital from January 2021 to March 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 40 patients in each group. The control group was treated with ordinary suture technique, and the observation group was treated with plastic and cosmetic surgery technique. The clinical efficacy, complications, perioperative index, scar state and wound pain degree were compared between the two groups. Results The total effective rate of treatment in the observation group was 97.50%, which was higher than 75.00% in the control group (P <0.05). The incidence of complications in the observation group was 7.50%, which was lower than 27.50% in the control group (P <0.05). The perioperative time, intraoperative blood loss and hospitalization time of the observation group were better than those of the control group (P <0.05). The scar color, blood vessel distribution, thickness and softness of the observation group were better than those of the control group (P <0.05). The wound pain degree of the observation group was better than that of the control group (P <0.05). Conclusion The application of plastic and cosmetic surgery suture in patients with facial trauma can improve the clinical efficacy, reduce the pain, and the operation time is short and the safety is high, which is worthy of application.