Objective To explore the effect of botulinum toxin type A injection on incision healing effect in patients undergoing plastic and aesthetic surgery. Methods A total of 100 patients who underwent plastic and aesthetic surgery at Beijing Fengtai You'anmen Hospital from July 2024 to June 2025 were selected as the research subjects, and they were divided into the reference group (n=50) and the experimental group (n=50) by the random number table method. The reference group was only treated with tension-relieving sterile tape, and the experimental group was treated with botulinum toxin type A injection combined with tension-relieving sterile tape. The incision healing effect, scar improvement effect and adverse reaction rate were compared between the two groups. Results The effective rate of incision healing in the experimental group was 96.00%, which was higher than 82.00% in the reference group (P<0.05). After treatment, the scores of scar softness, thickness, color, vascular distribution and overall appearance in the experimental group were lower than those in the reference group (P<0.05). There was no statistically signiffcant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion For patients undergoing plastic and aesthetic surgery, the combined application of botulinum toxin type A injection and tension-relieving sterile tape can effectively reduce postoperative incision tension, thereby promoting incision healing and improving scar appearance, without increasing postoperative adverse reactions, which has high treatment safety.