Objective To explore the effect of positive psychological intervention on mental health status and aesthetic effect in patients undergoing facial plastic and aesthetic surgery. Methods A total of 70 patients who received facial plastic and aesthetic surgery in General Hospital of Ningxia Medical University from July 2024 to July 2025 were selected. According to the random number table method, they were divided into the reference group and the study group, with 35 patients in each group. The reference group received conventional nursing intervention, and the study group received positive psychological intervention on the basis of conventional nursing intervention. The negative emotions, self-evaluation and self-acceptance levels, mental health status, aesthetic effect and satisfaction were compared between the two groups. Results After intervention, the scores of SAS and SDS in the study group were lower than those in the reference group (P<0.05). After intervention, the levels of self-evaluation and self-acceptance in the study group were higher than those in the reference group (P<0.05). After intervention, the scores of mental health in the study group were lower than those in the reference group (P<0.05). The total improvement rate of the study group (94.29%) was higher than that of the reference group (77.14%) (P<0.05). The satisfaction rate of the study group (97.14%) was higher than that of the reference group (80.00%) (P<0.05). Conclusion Positive psychological intervention for patients undergoing facial plastic and aesthetic surgery can not only improve their self-evaluation and self-acceptance levels and ameliorate mental health status, but also enhance aesthetic effect and surgical satisfaction, which is worthy of clinical application.