Objective To explore the effect of risk factor-based specialized intensive intervention combined with psychological support on postoperative recovery in patients undergoing facial scar repair. Methods A total of 82 patients undergoing facial scar repair admitted to Department of Medical Cosmetology, Nanjing Women and Children's Healthcare Hospital from February 2023 to February 2025 were selected as the research subjects, and they were divided into the control group and the study group according to different postoperative nursing methods, with 41 patients in each group. The control group received conventional nursing, and the study group received risk factor-based specialized intensive intervention combined with psychological support on the basis of the control group. The postoperative recovery, quantitative scar score, psychological state and adverse reactions were compared between the two groups. Results The wound healing time, skin blood supply recovery time and pain duration in the study group were shorter than those in the control group (P <0.05). The VSS score of the two groups at 2 weeks after intervention was lower than that before intervention, and that of the study group was lower than that of the control group (P <0.05). The scores of HAMA and HAMD in the two groups at 2 weeks after intervention were lower than those before intervention, and those in the study group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the study group (4.88%) was lower than that in the control group (21.95%) (P <0.05). Conclusion Risk factor-based specialized intensive intervention combined with psychological support has a definite effect in patients undergoing facial scar repair. It can effectively promote rapid postoperative recovery, improve scar symptoms, help to relieve patients' psychological pressure, and reduce the risk of adverse reactions.