Objective To investigate the application effect of modified tension-reducing cosmetic suture in patients with maxillofacial trauma. Methods A total of 62 patients with maxillofacial trauma admitted to Guangyuan Central Hospital from October 2022 to March 2024 were selected and randomly divided into control group and observation group, with 31 patients in each group. The control group was treated with traditional cosmetic suture, and the observation group was treated with modified tensionreducing cosmetic suture. The surgical effect, perioperative indexes (wound edema duration, wound healing time and surgical scar length), scar hyperplasia and adverse reactions were compared between the two groups. Results The total surgical efficacy rate in the observation group was 96.77%, which was higher than 77.42% in the control group (P <0.05). The edema duration, wound healing time and surgical scar length in the observation group were shorter than those in the control group (P <0.05). The VSS scores and total scores in the observation group were lower than those in the control group (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Compared with the traditional cosmetic suture method, the modified tension-reducing cosmetic suture method can improve the surgical efficacy of patients with maxillofacial trauma, shorten the duration of edema and wound healing time, reduce the length of surgical scars, and reduce the severity of postoperative scars. The application safety is high.