Objective To analyze the effect of nursing intervention based on PERMA model on skin aesthetic effect and psychosocial adaptation in patients undergoing scar plastic surgery. Methods A total of 120 patients undergoing scar plastic surgery admitted to Guizhou Provincial People's Hospital from April 2023 to March 2025 were selected and divided into the control group and the observation group by the random number table method, with 60 patients in each group. The control group received conventional nursing, and the observation group received nursing intervention based on PERMA model. The skin aesthetic effect, post-traumatic growth score, psychological resilience score and adverse reaction rate were compared between the two groups. Results The erythema index and melanin index in the observation group after intervention were lower than those in the control group (P <0.05). The scores of each dimension of psychological resilience and post-traumatic growth score in the observation group after intervention were higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 3.33%, which was lower than 16.67% in the control group (P <0.05). Conclusion The application of nursing intervention based on PERMA model in patients undergoing scar plastic surgery can effectively improve their skin erythema index and melanin index, enhance patients' post-traumatic growth level and psychological resilience, and reduce the incidence of adverse reactions.