Objective To explore the effect of nasolabial ffap on aesthetic effect in patients undergoing external nasal defect repair. Methods A total of 40 patients who received external nasal defect repair in our hospital from April 2020 to May 2025 were selected. According to the random number table method, they were divided into the control group and the study group, with 20 patients in each group. The control group received conventional repair, and the study group received nasolabial ffap repair. The aesthetic effect, scar status, ffap survival status, complications and subjective satisfaction were compared between the two groups. Results The nasal aesthetic scores of the study group at 1 and 3 months after operation were higher than those of the control group (P<0.05). The scar score of the study group was lower than that of the control group, the total ffap survival rate was higher than that of the control group, and the rates of partial ffap necrosis and total ffap necrosis were lower than those of the control group (P<0.05). The incidence of complications in the study group (10.00%) was lower than that in the control group (50.00%) (P<0.05). The subjective satisfaction rate of the study group (90.00%) was higher than that of the control group (65.00%) (P<0.05). Conclusion The application effect of nasolabial ffap in external nasal defect repair is deffnite. It can improve nasal aesthetic effect, optimize scar status and ffap survival status, reduce the risk of postoperative complications, and achieve high subjective satisfaction among patients, which is worthy of clinical application.