Objective To analyze the effect of refined nursing in plastic surgery for patients with maxillofacial trauma. Methods A total of 97 patients with maxillofacial trauma treated in our hospital from October 2020 to October 2023 were selected and divided into control group (n =48) and observation group (n =49) according to the random number table method. The control group received routine nursing, and the observation group was given refined nursing on the basis of the control group. The degree of scar, cosmetic effect, psychological state and complications were compared between the two groups. Results After 3 months of nursing, the VSS score, POSAS score and SAD score of the observation group were lower than those of the control group, and the SES score and SAQ score were higher than those of the control group (P <0.05). The total excellent and good rate of the observation group was 95.92%, which was higher than 83.33% of the control group (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05). Conclusion The application of refined nursing in plastic surgery for patients with maxillofacial trauma can improve the degree of scar, improve the cosmetic effect, regulate the psychological state, and reduce the incidence of complications.