Objective To investigate the effect of early psychological intervention combined with aesthetic nursing on mental health, scar aesthetics and complications in patients after abdominoplasty. Methods A total of 90 patients who underwent abdominoplasty in our hospital from January 2023 to January 2024 were selected, and they were divided into the control group (45 patients) and the study group (45 patients) by the random number table method. The control group received conventional nursing, and the study group received early psychological intervention combined with aesthetic nursing on this basis. The Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Vancouver Scar Scale (VSS) scores, complication rate and nursing satisfaction were compared between the two groups. Results After intervention, the scores of SAS, SDS and VSS in the study group were lower than those in the control group (P <0.05). The incidence of complications in the study group was 4.44%, which was lower than 20.00% in the control group (P <0.05). The nursing satisfaction rate in the study group was 93.33%, which was higher than 68.89% in the control group (P <0.05). Conclusion Early psychological intervention combined with aesthetic nursing can improve the postoperative mental health and scar aesthetics of abdominoplasty patients, reduce the incidence of postoperative complications, and increase patient satisfaction.