Objective To explore the efficacy and safety of polylactic acid in the repair of patients with skewed nasal prosthesis. Methods A total of 60 patients with skewed nasal prosthesis after nasal augmentation admitted to Chengdu Jinjiang Angela Medical Beauty Hospital from June 2022 to May 2023 were selected as the research subjects, and they were divided into control group (n =30) and observation group (n =30) by the random number table method. The control group was repaired with hyaluronic acid, and the observation group was repaired with polylactic acid. The repair satisfaction, facial angle, complications and repair effect maintenance were compared between the two groups. Results After treatment, the repair satisfaction score of the two groups was better than that before treatment, and that in the observation group was better than that in the control group (P <0.05). The upper lip angle of the nasal columella in the observation group was higher than that in the control group (P <0.05). There was no significant difference in nasal frontal angle, nasal facial angle, nasolabial angle and nasal tip protrusion between the two groups (P >0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). The good maintenance rate of repair effect in the observation group was 100.00%, which was higher than 90.00% in the control group (P <0.05). Conclusion The efficacy and safety of polylactic acid in the repair of skewed nasal prosthesis is accurate, which can effectively correct the skewed nasal prosthesis defect, so as to shape a good nasal morphology, and the maintenance of the repair effect is better, with higher repair satisfaction. It is worthy of clinical application.