Objective To explore the application effect of skin soft tissue expansion in the repair of facial and neck scar. Methods A total of 50 patients with facial and neck scars admitted to the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from April 2023 to April 2024 were randomly divided into control group and study group, with 25 patients in each group. The control group was treated with traditional scar resection, and the study group was treated with skin soft tissue expansion. The scar repair effect, quality of life, complication rate and patient satisfaction were compared between the two groups. Results The postoperative scar score of the study group was (5.60±1.90)scores, which was lower than (9.20±2.50)scores of the control group (P <0.05). The postoperative QOL-BREF scores of the study group were higher than those of the control group (P <0.05). The incidence of complications in the study group was 8.00%, which was lower than 28.00% in the control group (P <0.05). The satisfaction rate of the study group was 92.00%, which was higher than 56.00% of the control group (P <0.05). Conclusion For patients with facial and neck scars, skin soft tissue expansion is beneficial to improve the scar condition of patients, improve the quality of life and satisfaction of patients, and reduce complications, which is worthy of clinical application.