Objective To observe the effect of plastic and aesthetic surgery repair on the aesthetics and psychological state of patients with facial soft tissue injury during treatment. Methods Thirty patients with facial soft tissue injury admitted to the Eighth Affiliated Hospital of Xinjiang Medical University from January to December 2023 were randomly divided into control group (n =15) and observation group (n =15). The control group was treated with routine clinical repair treatment, and the observation group was treated with plastic and aesthetic surgery repair treatment. The repair effect, aesthetics, overall treatment effect, psychological state and complications were compared between the two groups. Results The skin function score of the observation group was higher than that of the control group, while the incidence of deformity and scar was lower than that of the control group (P <0.05). After treatment, the SCAR score and Face-Q score of the observation group were higher than those of the control group (P <0.05). The excellent and good rate of treatment in the observation group (100.00%) was higher than that in the control group (53.33%) (P <0.05). After treatment, the scores of SAS and SDS in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group (6.67%) was lower than that in the control group (40.00%) (P <0.05). Conclusion The application of plastic and aesthetic surgery repair in facial soft tissue injury can achieve ideal repair effect, which can improve the aesthetics, improve the psychological state of patients, reduce complications, and have high safety. It is worthy of clinical application.