Objective To explore the effect of dietary management under TCM health guidance on self-efficacy in patients after aesthetic plastic surgery. Methods A total of 120 patients who underwent aesthetic plastic surgery in Xuzhou Shining Cosmetology Hospital from January 2023 to January 2024 were selected as the research subjects, and they were divided into group A and group B by the random number table method, with 60 patients in each group. Group A received conventional nursing, and group B received dietary management under TCM health guidance on the basis of group A. The psychological resilience, quality of life, selfefficacy and adverse events were compared between the two groups. Results After nursing, the scores of psychological resilience, quality of life and self-efficacy in group B were higher than those in group A (P <0.05). The incidence of adverse events in group B (1.67%) was lower than that in group A (30.00%) (P <0.05). Conclusion The application of dietary management under TCM health guidance for patients after aesthetic plastic surgery can promote the adjustment of patients' psychological state after surgery, reduce the incidence of adverse events, and improve patients' quality of life and self-efficacy.