Objective To explore the application effect of minimally invasive aesthetic nursing based on facial anatomical zones in facial skin tumor excision. Methods A total of 90 patients who underwent facial skin tumor excision in our hospital from November 2022 to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 45 patients in each group. The control group received conventional nursing, and the observation group received minimally invasive aesthetic nursing based on facial anatomical zones. The facial aesthetics, scar condition, complication rate and nursing satisfaction were compared between the two groups. Results At 3 months after surgery, the score of facial aesthetics in the observation group was higher than that in the control group (P<0.05). At 3 months after surgery, the scores of all dimensions of VSS and total score in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group (4.44%) was lower than that in the control group (17.78%) (P<0.05). The nursing satisfaction of the observation group (97.78%) was higher than that of the control group (82.22%) (P<0.05). Conclusion The application of minimally invasive aesthetic nursing based on facial anatomical zones in patients with facial skin tumor excision can effectively improve scar healing, enhance facial aesthetics, reduce the incidence of complications, and increase patient satisfaction. It is worthy of clinical application.