Objective To explore the effect of "kite" ffap repair on pain intensity and aesthetic effect in patients with facial skin defect. Methods A total of 100 patients with facial skin defect admitted to the Department of Medical Cosmetology, Liyang Hospital of Chinese Medicine from February 2022 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group was treated with traditional excision and direct suture, and the observation group was treated with "kite" ffap repair. The pain intensity, aesthetic effect, complication rate and satisfaction were compared between the two groups. Results The scores of VAS in the observation group at 3 and 7 days after operation were lower than those in the control group (P<0.05). The excellent and good rate of aesthetic effect in the observation group was 92.00%, which was higher than 68.00% in the control group (P<0.05). The incidence of complications in the observation group was 12.00%, which was lower than 48.00% in the control group (P<0.05). The satisfaction rate in the observation group was 96.00%, which was higher than 68.00% in the control group (P<0.05). Conclusion The "kite" ffap shows good comprehensive efffcacy in the repair of facial skin defect. It can not only effectively reduce patients' pain and the risk of complications, but also achieve an ideal aesthetic effect, thus obtaining higher patient satisfaction.