Objective To observe the effect of flurbiprofen axetil (FAI) combined with propofol (PPF) anesthesia in plastic and cosmetic surgery. Methods A total of 60 patients who underwent plastic and cosmetic surgery in Nanjing Kangmei Beauty Hospital from October 2022 to October 2023 were selected as the research objects. They were divided into group A and group B by random number table method, with 30 patients in each group. Group A was anesthetized with FAI combined with PPF, and group B was anesthetized with PPF and ketamine. The anesthetic effect, recovery indexes and adverse reactions of anesthesia were compared between the two groups. Results The excellent and good rate of anesthesia in group A was 100.00%, which was higher than 93.33% in group B (P <0.05). The eye opening time and recovery time of group A were shorter than those of group B (P <0.05). There was no significant difference in Steward awakening score between the two groups (P >0.05). The incidence of adverse reactions of anesthesia in group A was 3.33%, which was lower than 13.33% in the control group (P <0.05). Conclusion FAI combined with PPF anesthesia for patients undergoing plastic and cosmetic surgery can not only achieve satisfactory results, but also have a stable anesthetic effect and less impact on patients. Patients can wake up quickly after surgery, with fewer adverse reactions and relatively high safety, which is worthy of clinical application.