Objective To explore the effect of modified tension-reducing cosmetic suture on scar formation in patients with maxillofacial trauma. Methods A total of 82 patients with maxillofacial trauma admitted to the Department of Otorhinolaryngology, Yancheng Dafeng People's Hospital from January 2022 to May 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 41 patients in each group. The control group was treated with traditional suture, and the observation group was treated with modified tension-reducing cosmetic suture. The wound healing time, pain degree, scar formation, patient satisfaction and adverse reaction rate were compared between the two groups. Results The postoperative wound healing time of the observation group was shorter than that of the control group (P <0.05). The VAS score of the observation group at 1 week after operation was lower than that of the control group (P <0.05). The scores of color, thickness, vascular distribution, softness and total score in the observation group after operation were lower than those in the control group (P <0.05). The patient satisfaction rate of the observation group was 92.68%, which was higher than 73.17% of the control group (P <0.05). The incidence of adverse reactions in the observation group (4.88%) was lower than that in the control group (19.51%) (P <0.05). Conclusion Modified tension-reducing cosmetic suture can effectively shorten the healing time of maxillofacial wounds, alleviate postoperative pain, inhibit scar formation, improve patient satisfaction, and has a low incidence of adverse reactions.